MASTERS COURSE in MICROFINANCE

APPLICATION FORM

To the Chancellor of the University of Bergamo

The undersigned

SURNAME______________________________________________ FIRST NAME_____________________________

Place of birth (specify town and country) ________________________________________ date of birth ____________
Tax code/ SOCIAL SECURITY NUMBER * _____________________________________________________________
Citizenship _________________________________________
Place of residence: Address (street and number) __________________________________________________
Postcode/ZIP____________________ Town _____________________________________________
State/Province ___________________________ Country ____________________________________
Telephone (home) _____________________ Telephone (at work) _________________________
Mobile phone ________________________ Email ____________________________________

* ALL FIELDS TO BE COMPLETED, EXCEPT THE TAX CODE/SOCIAL SECURITY NUMBER UNLESS REQUIRED IN THE
APPLICANT’S COUNTRY OF ORIGIN

HEREBY APPLIES FOR ADMISSION TO:

Level 1 Masters Course in MICROFINANCE

AND DECLARES TO HOLD

A non-Italian academic qualification

In (subject area) ________________________________ _________________________________________
Awarded by the University of _____________________________________________________________
on _____/_____/______ with the following GRADE_____/_____
‰ Already recognised equivalent to an Italian Degree by the University of
__________________________________, Chancellor’s Decree No. _________ of (date) _____________.
‰ Submitted with all the supporting documents and awaiting recognition of equivalence to an Italian
Degree for admission to the Masters Course. This requirement is a pre-condition for enrolment.
 AND ALSO DECLARES

‰ That he/she is not currently enrolled in a Diploma course, Degree course, Specialised Degree
course, Doctorate, School of Specialisation or Masters Course at this or any other University or
Higher Education Institution (Art. 142 of R.D. No. 1592, 31.8.1933).
‰ That he/she is enrolled in a _________________________________ (Degree, Specialised Degree,
etc.) course in (subject area) _____________________________________ at the Faculty of
_________________________ of the University of __________________________ but undertakes to
apply for suspension of studies if admitted to this course.
‰ That he/she is aware that the penalty for submitting false information is immediate cancellation of
the application and of the applicant’s academic record and loss of the right to reimbursement of
fees paid.

Address for correspondence:

(Street and number) ………………………………..…………………....
Town ........................................................................ Postcode/ZIP ……..…
Country: ..........................................................................................
Tel. …………………………… Email…………………………………….
(Reserved for communication with the University)

Current employment status:

‰ Unemployed
‰ Employed by ______________________________________
‰ Full-time
‰ Part-time

Documents enclosed:
‰ an original or authenticated copy of the Qualification, together with an official translation into Italian,
legalised and recognised (“legalizzazione e dichiarazione di valore in loco”) by the competent Italian
Diplomatic Representation in the country under whose law the academic qualification was issued);
‰ a Degree Certificate specifying the grade earned (and scoring scale) and a list of examinations passed,
with an official legalised translation into Italian.
‰ A signed CV covering the educational and career details needed for evaluation
‰ A signed Personal Profile form containing information needed for evaluation (form available on the
course webpage at www.unibg.it/masterbg);
‰ A back/front photocopy of the applicant’s passport
‰ Two letters of reference from the employer or academic/training institution
‰ Written permission from the employer (only for employed candidates) on the form provided in the course
webpage.
‰ A certificate proving the applicant’s knowledge of English, unless his/her academic qualification was
awarded by an English-speaking university.

……………………………….., …………… …………………………………….

(place) (date) (Signature)

Under the Italian Privacy Act (DLgs No. 196/2003) the University will safeguard the privacy of candidates
and treat their personal details accordingly. All data will be used exclusively for course development and for
managing teaching and administration, in the interest of students and of the University and in compliance
with regulations currently in force.

Where did you hear about this course?

‰ National press ‰ Internet – UniBG Website ‰ Word of mouth

‰ Local press ‰ Mail ‰ Other
‰ Radio ‰ Telephone ‰ No reply
‰ Microfinance specialists