Application form – Italian course – Marco Polo programme

First name and surname *

Email *


Choose your program *:


Gender *:


Date of birth *:


Place of birth (City, Province, Country) *


Citizenship *


Identity document (type and number) *


Permanent address
(Street and house number, Town/City, Province, Post code, Country) *


Knowledge of Italian*


Other known language


Indicate below if you have a disability

AUTHORIZATION *:
I authorize the University of Padua - Centro Linguistico di Ateneo, to process the above data, exclusively for institutional purposes in accordance with the information pursuant to Regulation (EU) 2016/679 of 27 April 2016 and subsequent amendments and integrations. The provision of such data is mandatory for the purposes of registration for the course.

I authorize

DECLARATION *:
I declare that the information and data provided are complete and truthful. I also declare to be aware of the provisions of art. 76 of Presidential Decree 28.12.2000, n. 445 on criminal liability in the event of false statements. I am obliged, if necessary, to communicate any change in the data set out above.

I declare

ACCEPTANCE*:
By filling in and sending this form I accept the contractual conditions indicated on the appropriate web page (http://cla.unipd.it/en/courses/marcopolo/)

I accept

(*) mandatory