EUTOPIA Impact Schools
Application Form 2024

Mandatory instructions for the application
●	Save this application form as a single PDF document, including the academic CV, the support letter(s), etc.
●	Entitle the file:  ImpactSchool_Surname_Name.pdf (e.g.: ImpactSchool_Rossi_Mario.pdf)
●	Upload the single merged PDF to the following Google Form: https://forms.gle/b1bDJ366h7AAGGfv6
●	Font: Calibri, minimum size: 11
Applications which do not respect the above requirements will be rejected.

1- Applicant details	
Surname(s)		
Name(s)		
Gender (M, F,  non binary, other, prefer not to say)		
Institutional email (mandatory: @unive.it)		
Phone number		

2- PhD dissertation	
PhD defense date		
PhD award date		
PhD dissertation title		
PhD awarding university(ies)		

3- Current position at UNIVE	
Position title (assistant professor, associate professor, etc…)		
Department		
Institute/ Research group 		
Name of the head of institute/ Research group		

4-  Motivation	
Please explain: 
1) your interest in the Impact School Programme and the EUTOPIA Alliance;
2) your expectations from the Impact School Programme in terms of training, skills development, impact and dissemination of your research, contribution to the EUTOPIA alliance, etc.
3) how you plan to contribute to the EUTOPIA Alliance and the Impact School
(max 2 pages)	

	

5- Mandatory annexes	
Please merge to the present form, in pdf format:
●	academic CV (maximum 4 pages), highlighting the publications, activities or achievements that are especially relevant to this application;
●	at least 1 support letter from direct hierarchy (Head of Department, Head of Research group, Vice rector for research, etc.)
●	certificate of English language: any certificate can be accepted, however  candidates holding an internationally recognised certification will have a priority. The list of international certifications recognised by Ca’ Foscari University of Venice is available at the following link: https://www.unive.it/pag/40609/?L=1	

I hereby declare that the information given by me in the application is true, complete and correct to the best of my knowledge and belief and that nothing has been concealed or distorted.

Signature:

Date: