Application form

To the Director of the Department of Environmental Sciences, Informatics and Statistics
Ca’ Foscari University of Venice
Scientific Campus, 
via Torino, 155
30170 Mestre Venezia

I, the undersigned ___________________________ born in _________________________ (Country ____) on _______________, passport no. / taxpayer’s code no. ___________________ resident in __________________ (Country _____), in ____________________ (street) no. _____, postcode _____________, nationality ________________, tel. ______________ mobile ______________________,   email ___________________________
hereby submit
within the scope of the research project with code 2120-0005-1463-2019, entitled IMIIAA - Soluzioni Intelligenti per il monitoraggio degli Inquinanti ambientali nelle Acque di dilavamento Autostradali”, as part of the 2019 regional call for applications - Decree of the Regional Government no. 1463/2019 - "Innovazione e ricerca per un Veneto più competitivo" (Innovation and Research to make Veneto more Competitive) - POR ESF 2014-2020 - Ob. "Investments to encourage growth and employment", my application for the call for applications for the short-term research fellowship for Advanced Visiting Fellow and for Young Visiting Fellow, as per resolution no. 601/2020 of 16/06/2020:
Choose one of the following positions, in the case no preferences are chosen the application will be evaluated against all of the available positions
•	Advanced Visiting Fellow Title ”Smart solutions for the real time modelling of runoff water quality”, lasting 1 months,  during the duration of the Project.
•	Young Visiting Fellow Title “Installation, maintenance and data analysis of smart monitoring systems”, lasting 1 months, during the duration of the Project.	

I, the undersigned, fully aware of the liabilities, including criminal liability, arising from untruthful declarations, pursuant the Italian law (D.P.R. 445/2000), hereby declare:
a)	 to hold the qualification of master degree / PhD / other…..  in _______________ obtained on ___________ at the University of/other Legal Entity________________;

in the event that the candidate does not hold the qualifications specified above, they shall be able to demonstrate their multi-year experience in:
[note for the Department/Centre: make clear the characteristics of the fellow's profile and the multi-year experiences that can justify the absence of the title]
b)	to be of  _____________ nationality [for non-EU citizens already residing in Italy only: to hold a residence permit/research visa for _________ expiry date________;
c)	to be physically fit for the position; 
d)	to be aware that the awarding of the short-term research fellowship is not compatible with the positions referred to in art. 12 of the Regulations for short-term research fellowships and the current legislation;
e)	to not have any kinship and affinity, up to and including the fourth degree, with any professor belonging to the Department or to the Centre announcing the call for applications, or with the Rector, the Chief Executive Officer or a member of the University Board of Directors and to be aware of the relevant provisions of Law 240/2010. Article 18, par. 1, lett b);
f)	to request the following benefits established by Law no. 104/92:
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and for the above mentioned purpose encloses disability certification;
g)	that any communication regarding this application shall be sent to the following address:
      ………………………………………………………………(street)   no………City ……………………... POSTCODE……              PROV/Country……………………tel. …………………..  land line ……………………………  mobile ………………………
email  ………………………………………………, undertaking to communicate any subsequent variations and recognising that the administration accepts no liability in the event of the addressee being untraceable.
i) to give my consent for the personal data provided to be processed, in compliance with Legislative Decree no. 197/2003 and EU Regulation no. 2016/679, for recruitment purposes related to this selection procedure;

The following are enclosed to this application: 
a)	 a CV detailing professional, academic and research background;
b)	copy of an identity document;
c)	any other element  required by the call;
d)	any other documentation deemed relevant for the evaluation.

      Date and signature  
________________________

The University does not take any responsibility for cases of unavailability of the recipient or for the dispersal of communications resulting from inaccurate indication of domicile or of contact details by the candidate, failure or late communication of contact details’ variation or any other reason not attributable to the University, nor from any error in postal delivery, or in any case from acts attributable to third parties, from unforeseeable circumstances or force majeure.
The declarations made in the application shall be considered made pursuant to the D.P.R. n. 445/2000 and subsequent amendments, by candidates entitled to use the simplified administrative certifications allowed by the aforementioned decree.