LAB-留学申込フォーマット

APPLICATION FORM

LAST    NAME

FIRST  NAME

PLACE OF BIRTH

DATE OF BIRTH

SEX MALEFEMALE

COUNTRY  

NATIONALITY  

HOME ADDRESS  

TOWN  

POST CODE  

COUNTRY  

PHONE NUMBER  

CELL-PHONE (IF ANY)  

E-MAIL   

PASSPORT NUMBER AND   

DATE OF ISSUE  

SECONDARY - SCHOOL DIPLOMA  

UNIVERSITY DEGREE  

DEPARTMENT  

UNIVERSITY CITY  

CURRENT POSITION  

LEVEL OF ITALIAN ATTAINED *BASICINTERMEDIATEADVANCED

ITALIAN COURSE(S) TAKEN AT A UNIVERSITYAN ITALIAN CULTURAL INSTITUTESOME PRIVATE INSTITUTION

REFEREE(S)  

PROF.  

SPECIAL NOTES  

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documents to be attached to application: .pdf, .doc or .rtf (maximum 1,50 MB Mb)
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CURRICULUM VITAE

SCHOOL-LEAVING CERTIFICATE AND/OR DEGREE

CERTIFICATE(S) AS TO THE KNOWLEDGE OF ITALIAN

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For immigration formalities, please, remember to bring with you 5 passport-size photos for non-EU,
1 for EU citizens. (.jpeg maximum 1,50 MB) *
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PICTURE  

SHOULD IT BE POSSIBLE, I WOULD VERY MUCH LIKE TO BE ACCOMODATED
IN A DOUBLE ROOM WITH A LOCAL FAMILY;IN A DOUBLE ROOM AT THE STUDENTS' HALL;

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for your guidance, please note the following:
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I SUFFER AN ALLERGY TO  

I'M A VEGETARIANYESNO

AND SO ON AND SO FORTH  

私はロボットではありません  

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