ANNEX  1 – APPLICATION FORM
University Corridors for Refugees - UNICORE 2.0 (Ethiopia 2020-2022)
To be sent via email to unicore@adm.unipi.it  in compliance with  art. 4

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(Please complete this application form in capital letters)
PERSONAL INFORMATION
Surname          ………………………………………………………………………..
Name                ………………………………………………………………………..

Date of birth     ………………………….:………………………………………….
(dd/mm/yyyy)  	   				
Place of birth    ..…………………………………………..............................
( Town/Country)
Refugee ID card number ……………………………………………………….
and/ or Ration Card Number of Proof of  Recognition ……………………………………………………
     
Citizenship    	………………………………………………………………………
Gender         	 ………………………………………………………………………    
City /Country of residence  …...………………………………………………..    
Address        	….…………………………………………………………………..		       
Mobile phone 	……………………………………………………………………….
E-mail                  .………………………………………………………………………
Skype/other platform account ….……………………………………………..

SELECTED PROGRAMMES  (MAX TWO options, in order of preference among those listed in Annex 2 )
1.	_________________________________

2.	_________________________________

HAVE YOU APPLIED FOR OTHER UNIVERSITIES WITHIN PROJECT?
(If you have, please list the University and the selected degree programme)

1.	_________________________________

2.	_________________________________

3.	_________________________________

PERSONAL STATEMENT
Please briefly summarize (about 5 lines) your professional profile, your future professional goals and your motivation.
…............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

WORK EXPERIENCE
From …. To …..:
Job role   …......................
Company or Institution name …......................
Brief description of your role and responsibility 
…......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
From …. To ….:
Job role   …......................
Company or Institution name …......................
Brief description of your role and responsibility 
…......................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................

EDUCATION
Bachelor’s Degree
Complete name of the final qualification ………………….…...........................................
Graduation Date     ….................................................................................................
Awarding University …...............................................................................................
Faculty/Department …...............................................................................................
Thesis title (if any) …..................................................................................................
Final score (if any) …..................................................................................................

Cumulative Grade Point Average (GPA)  ….................................................................................................
(GPA documentation should be included in the application including each semester GPA and cumulative GPA)
High school Diploma
Complete name of the final qualification ….................................................................................................
Name of high school ….................................................................................................
Graduation Date      …..................................................................................................
Final Score (if any)  ..….................................................................................................

Other educational experiences
School name (with town and country) ……..................................................................
Course/programme title ….................................................................................................
From …. to ….

LANGUAGES
Level of language proficiency: M: mother tongue, A: elementary, B: intermediate, C: advanced
LANGUAGE	WRITING LEVEL	SPEAKING LEVEL	

			

Language certifications:
Please list here any language certification achieved. If available, please attach to the application a scanned copy of the certification
…...................................................................
…...................................................................

COMPUTER SKILLS
Brief description of  your computer skills
………....................................................................................................................................................................
………....................................................................................................................................................................

PERSONAL SKILLS
Brief description of your personal skills

………....................................................................................................................................................................
………....................................................................................................................................................................

HOBBIES
………....................................................................................................................................................................

I authorize the processing of personal data contained in this  application form according to art. 13 of Legislative Decree 196/2003 and art. 13 GDPR (EU Regulation 2016/679) for the sole purpose of personnel research and selection.

I give consent to publish my Refugee ID card number or Ration card number of my Proof of Recognition in the final ranking list of admitted  candidates on the website http://universitycorridors.unhcr.it/ and http://www.unipi.it/unicore 

I hereby declare to fully accept all the terms and condition specified  in the UNICORE 2.0 Call for applications for 2 study grants and welcome services for refugee students registering for Second Cycle degree programmes taught in English at the University of Pisa, for the Academic Years 2020-22.
I also declare to promptly inform the University of Pisa of any change it may occur in my personal data.

Place and Date 							Signature
__________________________                                                         _______________________________        

Check list of the required documents to annex to the application form: 
	A Copy of your currently valid Refugee Identity Card and/or the Proof of Registration issued in collaboration with UNHCR;
	An official certificate confirming the qualification required for admission to the selected degree programme and issued by the awarding university; 
	Official transcript of exams passed and relative marks; 
	Any other relevant and additional document required by the specific selected degree programme (included but not limited to a certification of English language profieciency, see Annex 2). 
	A motivation letter (maximum two pages).

•	A short video CV (e.g. using mobile phone) introducing yourself and your motivations.
(Examples for a video CV creation can be found in Google.com. Candidates can send the video via https://wetransfer.com/ to the email address unicore@adm.unipi.it) 
 Applicants will be emailed on the video receipt.  It is not required to annex the video to the requested documentation.
IMPORTANT: All documents submitted by applicants should be in English or Italian language.
All documents in any language other than Italian or English must be supported by a translation into English or Italian on plain (no letterhead) paper. During the application stage, it is not required a certified translation, but it is mandatory to provide the original documents.