Application form _prepare on plqin paper_

							Application form (prepare on plain paper, adapting it to your needs)


To the President of the Scuola Normale Superiore
Servizio Segreteria Allievi
Piazza dei Cavalieri n.7
56126 PISA (ITALY)

The undersigned (Family name, given name) __________________________________
born in (city, postal code, nation) ___________________________________________
on____________________________________________________________________
permanent address (city, postal code, nation) __________________________________
in house/apt no _______street/square… ______________________________________
(complete the following if place of residence different from permanent address)
resident in (city, postal code, nation__________________________________________
in house/apt no _______street/square… ______________________________________
telephone number _______________________________________________________
email address ___________________________________________________________

requests to be admitted to the 2011/2012 academic year entry exams for the following student
position(s) in the PhD program of the Faculty of Sciences:

[candidates may apply for one or more positions, by checking the relative box(es)]

  4 places available in Molecular Biophysics, in partnership with the IIT – Italian Institute of
   Technology
  4 places available in Chemistry
  5 places available in Physics
  3 places available in Condensed Matter Physics, in partnership with the Silvio Tronchetti
   Provera Foundation
  2 places available in Condensed Matter Physics, in partnership with the Nanoscience Institute of
   the CNR, relative to the following research fields:
   o Study of the transport properties of heat in superconductive hybrid nanostructures
   o Study of the spin effects in hybrid nanodevices based on superconductor-nanothreads
  5 places available in Mathematics
  3 places available in Mathematics for Industrial Technologies or for Finance, in partnership with
   the National Institute of Geophysics and Volcanology (INGV) and the Consorzio Pisa Ricerche:
   o specialization in Mathematics for Industrial Technologies
   o specialization in Mathematics for Finance
  1 place available in Neurobiology

The undersigned declares on his/her own responsibility:
a) to be a citizen of (indicate nationality)______________________________;
b) only for the candidates to the two positions in Condensed Matter Physics in partnership with the
    Nanoscience Institute of the CNR: not to have resided in or in any event carried out in Italy the
    prevalent activity for more than twelve months in the three years preceding this Call’s deadline;
c) never to have been definitively sentenced to prison (for more than three years);
d) never to have been expelled from the SNS;
e) not to have applied more than once for a PhD at the SNS ;



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f)  only for the candidates to the two places in Condensed Matter Physics in partnership with the
    Nanoscience Institute of the CNR: to have completed a MS/MSc, or diploma of a similar level
    for degrees earned abroad, no more than four years ago:
        - at the University ______________________________________________________
        - degree program ______________________________________________________
        - year enrolled _________________________________________________________
        - date MS/MSc degree completed __________________________________________
        - mark (GPA) __________________________________________________________
        - not to have completed a research doctorate (PhD) or equivalent:
g) to have earned a MS/MSc degree or equivalent (excluding the candidates in point f above)
        - at the University ______________________________________________________
        - degree program ______________________________________________________
        - year enrolled _________________________________________________________
        - date MS/MSc degree completed __________________________________________
        - mark (GPA) __________________________________________________________
h) only for candidates who have not yet completed their degrees(excluding the candidates in point f
    above)
    - to be enrolled in the degree program _______________________________________
    - at the University _______________________________________________________
    - year enrolled __________________________________________________________
    - to have requested admission to the MS/MSc degree exam:      YES           NO
    - to certify the MS/MSc diploma will be delivered within 31 October 2011;

i) to know English and/or Italian as indicated in more detail in the declaration attached to this
      application [use of the Europass language passport and module are recommended:
       http://www.europass.cedefop.europa.eu/europass/home/hornav/Downloads/LangPassport/ELPTemplate.csp ]

j) only for candidates whose diploma is from a nation not belonging to the European Higher
     Education Area:
-to have requested results from the GRE General Test and the GRE Subject Test be sent to the SNS

k) only for candidates with disabilities (Italian law 104, art.20, 5 February 1992):
     - that s/he intends to use the assistance and/or extra time needed to take the exam(s), as indicated
     :_____________________________________________________________

The undersigned is aware of the legal penalties for false statements made in public documents (Italian
pres. decree 445 art. 76, 28 December, 2000).
The undersigned further declares:
l) to wish to take the written exam(s) in English, where possible:                            YES              NO

m) only for candidates not resident in Italy:
- to require housing in the colleges of the SNS at least for the first three months of the PhD program,

n) to be aware and take note of the information concerning the use of personal data contained in the
Further Information pages at point a.11.

The undersigned attaches to this application:
  1. curriculum vitae et studiorum;
  2. declaration or certification relative to the information requested at points f), g) and h) above;
  3. self-certification or certification of all credit-bearing exams taken at university and marks
      obtained (transcript);
  4. copy of the MS/MSc degree thesis;
         [for MS/MSc theses not written in Italian or English, the candidate must attach an abstract of the thesis in either of
         these two languages, along with the thesis itself]
     5. no._________ recommendation letters;
     6. copy of proposed research project;
     7. self-certification of language skills (English or Italian);



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  8. other statements or documentation which the candidate wishes to attach to be evaluated;
  9. copy of a valid identification document.

The undersigned requests, lastly, that all communication relating to the present competition be
directed to the address indicated in this application, s/he undertakes to communicate possible future
variations of said address, and s/he recognizes that the Scuola Normale Superiore accepts no
responsibility for the any communication not delivered.


Signature of candidate ________________________




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