To the Director of the Department/Centre/… ______________
of Ca’ Foscari University of Venice 
(address of the Department/Centre/…)

I, the undersigned ___________________________ 
born in (City/Town name)______________________________ (Province/Region of _________, Country ___________) on (date) _______________, passport no. _____________ taxpayer’s code no. (if available) __________________________________ 
resident in (City/Town name) __________________ (Province/Region of _________, Country ___________) in Street/Square/…____________________ (indicate the street/square name) no. _____, postcode _____________, nationality ________________, tel.(national prefix included) __________________ mobile number (national prefix included)  ______________________,   email address___________________________

hereby submit

my application for the public selection based on qualifications, project proposal and interview for the call for applications to shortlist researchers allowed to submit collaborative proposals.

I, the undersigned, fully aware of the liabilities, including criminal liability, arising from untruthful declarations, pursuant the Italian law (D.P.R. 445/2000), hereby declare that:

a)	I have already submitted an individual proposal such as Marie Skłodowska Curie Actions - Individual Fellowships/ERC Starting Grant/FIRB (Italian Fund for basic research investments)/SIR (Scientific Young Independence Research) or similar (please delete as appropriate), with the title (please, indicate the name of the project)________, and having passed all the evaluation thresholds, as established by the related notice(please indicate the title and – if appropriate – the code of  the notice) ____________. The proposal obtained the following evaluation:_____ (please attach any relevant evaluation summary report);
b)	I have already completed an individual project under Marie Skłodowska Curie Actions - Individual Fellowships/ERC Starting Grants/FIRB (Italian Fund for basic research investments) / SIR (Scientific Young Independence Research), or similar funded projects, with the title (please, indicate the name of the project and its start and end dates)________, submitted under the programme (please, indicate the name of the programme and the related notice)________________________. (Please attach relevant evaluation summary report);
c)	I am aware that the research fellowship is not compatible with the positions indicated in art. 4 c. 8 and 18 of the Regulations on research fellowships awarding and the current laws;
d)	I am / I am  not (delete as appropriate) a permanent employee of any private-sector body and I declare that I am a part time employee / I am not a part time employee (delete as appropriate); furthermore, I am aware that the research fellowship is not compatible with the positions indicated in art. 4 c. 8 and 18 of the Regulations on research fellowships awarding and the current laws.