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APPLICATION F ORM(To be filled in block letters or typed)

The Rector of the University of NaplesFederico II, Office of the School of

specialization and Masters

Via Mezzocannone, 16 80134-Naples

Public competition for Master titles, 20 seats for admission toII Level Master in �Design of Steel Structures in Smart

Cities� for the academic year 2013/2014, announced at the

SUBJECT: Department of Structures for Engineering and Architecture incooperation with Department of Civil, Architectural and

Environmental Engineering by the University of NaplesFederico II

The undersigned ----------------------------------------------------------------------------- --(indicate name and surname)

RE! QUEST TO

the admittance/public competition of the 20 seats for Master title in �Design of Steel

Structures in Smart Cities� for the academic year 2013/2014, announced at the Department

of Structures for Engineering and Architecture by the University of Naples Federico II,

Naples ITALY.Pursuant to Article (75 and 76 of the Italian Executive order D.P.R. 28 December 2000, N0.

445), on the understanding of the criminal liability that may arise from false statements or

statements containing untruthful data, will be the responsibility of:

1 1: PERSONAL INFORMATION

Fam�ynamelllll ll I Illll

Firstname LL! 1 1 IA?! 1 l l l I

Nationality Sex Marital status Single Married

§�"<1:�:e3<) ¢�;~z::�«:z_ue«3 aii �.~3VI3tl_t533C2 teggicrsxxiia

Mérr 3.: iii 2 E :1

Place of birth

Countryofbirth C

Date ofbirth C

Passport No CA ): EDUCATIONAL BACKGROUND

a). Master degree (if any)Name of the University: ____________________________________________________________ __Address of the University: __________________________________________________________ __

Type of studies: _________________________________________________________ __

Duration: From (dd/mm/yyyy): __________ __To (dd/mm/yyyy): _________ __Official duration of the programme (in academic years): _____________ __

Title of degree: _____________________ __Grade obtained: _____________________ __

Official language: ____________________ __Title of dissertation/project: ___________ __

Results or grade: ________________________ __

b). Bachelor degree (minimum 4 years or above 4 years)Name of the University: ____________________________________________________________ __Address of the University: __________________________________________________________ __

Type of studies: _________________________________________________________ __

Duration: From (dd/mm/yyyy): __________ __To (dd/mm/yyyy): _________ __Official duration of the programme (in academic years): _____________ __

Title of degree: _____________________ __Grade obtained: _____________________ __

Official language: ____________________ __Title of dissertation/project: ___________ __

Results or grade: ________________________ __

B ): CONTATCS

Phone No.

Cell No

Email:

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§&#39;~z>ea�§\) %3u¥s)i$*¬§ (ii s;x.r:J,u§>c><% sxrrgamsils "

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Private address

(Changes in address should be immediately communicated to the master coordinator.)Street name and number: ______________________________________________ __

P.O. Box/Postal Bag: ______________________________________________ __Postal code: ______________ __ City: ___________________________________ __

C : ATTACHMENTS

For the above-mentioned purposes, please �nd attached: (Please remove the option,which do not apply)

. Copy of the front / back of its own identity document valid, duly signed;Copy of thesis � undergraduate

Copy of thesis � graduate

. Any pubblicatonsDescriptive list of all titles submitted;

Self� certification degree required as a prerequisite for admission art. 3 of thecompetition notice containing the final vote and list of exams with the grades

obtained (with details of their credits and SSD) and title of the thesis. For foreignstudents for self � certification is intended the certificate issued from the university

(having the passed exams, credits/hours and maximum and minimum score for each

class) signed by the student.

F&#39;JF�U.0.°°>G. Curriculum vitae in which is included any information about previous job

experience in the field of structural engineering.

Signature of the applicant: ------------------------- --Name of the applicant:Surname of the applicant:

Place (where application is signed): Dated:

Page [3/7]

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DELIVERY RECEIPT

(On behalf of the applicant)Certified that Mr./Ms. __________________________ __has applied for the publicparticipation in the Competition for 20 seats for the admission to the Master II Level

in �Design of Steel Structures in Smart Cities�, for the academic year 2013/2014,announced at the Department of Structures for Engineering and Architecture by the

University of Naples Federico II, Naples ITALY.

Signature of receiving person: _________________________ __

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V , umez�»:=/�J /&#39;.}/,xm,.,,«,)«,a7

H��wa3é?%§�3�%§£.%§�%§i;% raw veer?�APPLICATION FORM 2

(To be filled in block letters or typed)

The Rector of the University of NaplesFederico II, Office of the School of

specialization and Masters

Via Mezzocannone, 16 80134-Naples

Public competition for Master titles, 20 seats for admission toII Level Master in �Design of Steel Structures in Smart

Cities� for the academic year 2013/2014, announced at the

SUBJECT: Department of Structures for Engineering and Architecture incooperation with Department of Civil, Architectural and

Environmental Engineering by the University of NaplesFederico II

The undersigned ----------------------------------------------------------------------------- --(indicate name and surname)

RES QUEST TO

the admittance/public competition of the 20 seats for Master title in Design of Steel

Structures in Smart Cities for the academic year 2013/2014, announced at the Department

of Structural Engineering by the University of Naples Federico II, Naples ITALY.Pursuant to Article (75 and 76 of the Italian Executive order D.P.R. 28 December 2000, No.

445), on the understanding of the criminal liability that may arise from false statements or

statements containing untruthful data, will be the responsibility of (1):

1!: PERSONAL INFORMATION

Fam�yname

Firstname 1111,11 I l_L 1l1|1lLl|

Nationality

Sex Marital status [Single 1 Married 1 1

1111111111 11

, mrrccs ,ea Qosnggafgfiviié

Date of birth

Passport No C

DECLARES THAT

the achievement of the degree indicated in the application form (Form 1) as a requirement

for admission to the competition in the subject has passed the following subjects withcredits in dates and with the scores of each as indicated:

, Obtained

0303030-IUJUJUJUJOJUJIO \D®\l@Ul-BU-ll0Dd©\D

Signature of the applicant: ------------------------- --Name of the applicant:Surname of the applicant:

Place (where application is signed): Dated:

ATTENTION

In order to facilitate and make timely administrative controls , the candidates are argued to

attach copy of the certificate of transcripts (detail mark sheets )