INTERCULTURAL EDUCATION THROUGH RELIGIOUS STUDIES
Religions, Fundamentalism and Human Rights in School Education

APPLICATION FORM FOR EU AND EXTRA-EU APPLICANTS
(Application period: 08 January – 20 April 2018)

This application form must be filled in, signed and submitted via email to iers.comenius@unive.it

Applicants must provide also a copy of a valid passport, OR national ID card if EU citizens.

Name* ________________________________________________________________________________

Surname* ______________________________________________________________________________

Place and date of birth*___________________________________________________________________

Number of Passport/ID card* ______________________________________________________________

Nationality* _____________________________________________________________________________

Address (Usual place of residence)* _________________________________________________________

______________________________________________________________________________________

Email*________________________________________________________________________________

Phone*________________________________________________________________________________

Name of School/Organization* _____________________________________________________________

Profession______________________________________________________________________________

Age of students taught (if applicable)_________________________________________________________

Subject taught (if applicable) _______________________________________________________________

Erasmus Plus Applicant* YES/NO 

Self funding* YES/NO

* Mandatory information

	Date _______________ Signature __________________________________________________________

I, _______________, authorize the treatment of my personal data by Ca' Foscari University of Venice in compliance with the Italian Legislative Decree 196/2003 and the principles of correctness, fairness, transparency and protection of privacy and rights.

	Date _______________ Signature __________________________________________________________