UNIVERSITY OF TURIN FACULTY OF LAW WIPO WORLDWIDE ACADEMY

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UNIVERSITY OF TURIN FACULTY OF LAW WIPO WORLDWIDE ACADEMY MASTER OF LAWS (LL.M.) IN INTELLECTUAL PROPERTY APPLICATION FORM FAMILY NAME ............................................................. FIRST NAME ............................................................................ PLACE OF BIRTH ......................................................... DATE OF BIRTH ...................................................................... NATIONALITY…...................................... ……………SEX .......................................... ................................................. FULL ADDRESS ................................................................................................................................................................. .............................................................................................................................................................................................. TELEPHONE (area code) ............................................... (number) ..................................................................................... FAX ......................................................................................................... E-Mail ............................................................... EDUCATION * Type of university degree ..................................awarded on................................................ Major/ specialisation............................................................................................................. Name of university................................................................................................................ Final grade (if available)....................................................................................................... ........................................................................................................................................... * Type of High school/Secondary school Certificate .............................................................. awarded on............................. ................................... grade obtained .................................. * undergraduate in ................................................................................................................... at ...........................(town) (name of University) .................................................................. faculty ................................................................................................................................... * other degrees/certificates ...................................................................................................... (please specify) ..................................................................................................................... ENGLISH LANGUAGE (please indicate level of knowledge and certificates obtained) mother tongue ρ excellent ρ good ρ certificates obtained ................................................................................................................. ................................................................................................................................................. ................................................................................................................................................. LANGUAGE KNOWLEDGE, IN ADDITION TO ENGLISH (please indicate level of knowledge and certificates obtained, if any) .............................................................................................................................................................................................. .............................................................................................................................................................................................. .............................................................................................................................................................................................. WORK EXPERIENCE .............................................................................................................................................................................................. .............................................................................................................................................................................................. .............................................................................................................................................................................................. .............................................................................................................................................................................................. .............................................................................................................................................................................................. .............................................................................................................................................................................................. OTHER RELEVANT INFORMATION .............................................................................................................................................................................................. .............................................................................................................................................................................................. .............................................................................................................................................................................................. Signature .............................................................. Date ...................................................................... NOMINATING AUTHORITY .............................................................................................................................................................................................. Signature .............................................................. Date ...................................................................... N.B. Enclosures (copies) * University degree, specifying the results of the examinations * Certificates or other evidence testifying English language knowledge * Detailed Curriculum Vitae * Other supporting documents ......................................................................................................... ....................................................................................................................................................... ....................................................................................................................................................... THE APPLICATION FORM SHALL BE TAKEN INTO CONSIDERATION ONLY IF ACCOMPANIED BY THE SUPPORTING DOCUMENTS LISTED ABOVE APPLICATION AND SUPPORTING DOCUMENTS WILL NOT BE RETURNED World Intellectual Property Organization Worldwide Academy 34 chemin des Colombettes, 1211 Geneva 20, Switzerland Phone (41 22) 338 8585 Fax (41 22) 740 1417

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