Please read the following notes carefully before completing the application.

1. The dates of the Summer School on Development 2007 are:
   1 July – 6 July 2007
   Closing date for applications: April 15, 2007
   
   
2. Applications to the Summer School are assessed on the basis of the information provided. If the information provided is insufficient, we may not consider the application. We advise you to provide as much information as necessary in section 2 of the form.
   
   
3. As well as giving details of your academic background and prerequisite courses on this form, you can also send a copy of any academic transcripts and any English proficiency certification, by post, to the Unidea – UniCredit Foundation secretariat (address below).
   
   
4. COMPLETED APPLICATION FORM MUST BE SUBMITTED BOTH ELECTRONICALLY AND IN PAPER COPY. If you do not submit your completed application both electronically and in paper copy, it will not be considered complete and will not be reviewed. Only applicants facing specific problems and whom have been explicitly authorized by Unidea – UniCredit Foundation can apply by submitting only the paper copy of the application form (please contact the e-mail address below). Unfortunately, we cannot accept faxed or emailed application forms. If you would like help in completing the form, please contact the Unidea – UniCredit Foundation secretariat.
   
   

   E-mail: summerschool@unicreditfoundation.org

   Post to:

   Unidea – UniCredit Foundation
   Via San Protaso, 3
   20121 Milan
   Italy

(* = mandatory field)

SECTION 1 : PERSONAL DETAILS
Family Name/Last Name *
Given Name/First Name *
Title *
Gender *		Male Female
Date of Birth *		Month January February March April May June July August September October November December / Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 / year 1920 1921 1922 1923 1924 1925 1926 1927 1928 1929 1930 1931 1932 1933 1934 1935 1936 1937 1938 1939 1940 1941 1942 1943 1944 1945 1946 1947 1948 1949 1950 1951 1952 1953 1954 1955 1956 1957 1958 1959 1960 1961 1962 1963 1964 1965 1966 1967 1968 1969 1970 1971 1972 1973 1974 1975 1976 1977 1978 1979 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2005 2005
Place of Birth *
Nationality *
Correspondence Address *
Country of Residence *
E-mail address *
Home telephone number with international code
Mobile phone number with international code
Work telephone number with international code
Current Occupation: *		Student/Researcher Academic Practitioner/Expert/NGOs Other (specify)
SECTION 2: QUALIFICATIONS AND GENERAL EDUCATIONAL BACKGROUND
UNDERGRADUATE:
University NAME, PLACE AND COUNTRY Please give complete address
Degree Type
Subject
Result
Date awarded or expected
MASTER or equivalent:
University NAME, PLACE AND COUNTRY Please give complete address
Degree Type
Subject
Result
Date awarded or expected
Ph.D. and Post-doc and equivalent:
University NAME, PLACE AND COUNTRY Please give complete address
Degree Type
Subject
Result
Date awarded or expected
List any significant publications or relevant documents you have written concerning the topics of Summer School on Development 2007
English as Second Language: If English is not your first language; enter the test type score/grade and date (e.g. British Council, IELTS or TOEFL, Cambridge First Certificate) in the box below: *
Academic Referee: Please give details of at least three persons whom we may contact concerning your application and student/work status.
1. Name
1. Address
1. Position
1. E-mail
2. Name
2. Address
2. Position
2. E-mail
3. Name
3. Address
3. Position
3. E-mail
SECTION 3: GENERAL INFORMATION
EMPLOYMENT RECORD: starting with your present post, list in reverse order every employment you have had.
PRESENT POSITION
Type of business
Name and Address of Employer
From/to
Title of your post
POSITION
Type of business
Name and Address of Employer
From/to
Title of your post
POSITION
Type of business
Name and Address of Employer
From/to
Title of your post
Any other information about your academic-professional career and experience:
Where did you learn about the Summer School on Development 2007? *
		Web University NGOs Friends/previous student/colleagues Employer Other (specify)
Please tick the following box to confirm that you have read, understood and agreed to the terms and conditions of the Summer School on Development 2007. *
		I declare that the information supplied in this form is true to the best of my knowledge and belief.