Application form

University of Sassari
Department of Economics
and Woody Plant
Ecosystems (DESA)
You are invited to respect the deadline
14 AUGUST 2009
for returning this form
APPLICATION FORM
Academic Year 2008/09
SUMMER SCHOOL ON
“CLIMATE CHANGE AND AGRICULTURE”
Alghero, Sardinia - Italy 14-18 September 2009
PERSONAL DETAILS
NAME and SURNAME
DATE AND PLACE OF BIRTH
NATIONALITY
M
F
SEX (M/F)
PERMANENT ADDRESS
TEL. N° and MOBILE N°
(include international dialling code)
FAX N°
(include international dialling code)
E-MAIL
If student
HOME UNIVERSITY DATA
NAME AND ADDRESS
Application form
SUMMER SCHOOL ON
“CLIMATE CHANGE AND AGRICULTURE”
Alghero, Sardinia - Italy 14-18 September 2009
1
University of Sassari
Department of Economics
and Woody Plant
Ecosystems (DESA)
FACULTY
DEGREE COURSE
FIELD OF STUDY
LANGUAGE COMPETENCIES
I declare to have an adequate knowledge of English
THIS FORM, FILLED IN AND SIGNED, MUST BE RETURNED BOTH BY MAIL AND ORDINARY
MAIL TO:
E-MAIL:
[email protected]
mail
Università degli Studi di Sassari
Dipartimento di Economia e Sistemi Arborei
DESA
Via E. De Nicola 9
07100 Sassari
I authorize the processing of my personal data in compliance with the Italian Data Protection Law in force (D.Lgs.
196/2003).
YES

NO

Date:_________________ Signature: :_______________________________
Application form
SUMMER SCHOOL ON
“CLIMATE CHANGE AND AGRICULTURE”
Alghero, Sardinia - Italy 14-18 September 2009
2