TO THE DIRECTOR OF THE DEPARTMENT OF GENERAL PSYCHOLOGY –
UNIVERSITY OF PADUA

The undersigned

Surname	Name	Tax code	

		
Date of birth	Place of birth	Country of birth	

		
Address 	City of residence	Town or foreign Country of residence	

		
Post Code	Telephone number	Email address	

Requests

to be admitted to participate in the call for the “Vittorio Rubini” Award for Research in Psychology, aimed at recognizing the scientific excellence of PhD graduates enrolled in the XXXVII cycle of a doctoral programme at the University of Padua and who have formally obtained the degree by March 2026, with a dissertation in the field of Psychological Sciences or related disciplines

For this purpose,

pursuant to Articles 46 and 47 of Presidential Decree no. 445 of 28 December 2000, aware of the administrative and criminal sanctions referred to in Articles 75 (Loss of benefits) and 76 (Criminal provisions) in cases of false statements and declarations,

declares

□	to hold a PhD degree obtained on …………………………… at ………………………………… programme ……………………………, cycle ……. .
□	not to have any marital relationship or kinship or affinity, up to the fourth degree inclusive, with a professor or permanent researcher belonging to the Centre or to the host research structure, nor with the Rector, the General Director, or a member of the University Board of Directors;

Pursuant to Articles 46 and 47 of Presidential Decree 445/2000

also declares

□	that the information stated in this application is true and correct;

Attachments:
□	full copy of the dissertation in PDF format;
□	abstract (max 5,000 characters) including objectives, methods, results and contribution;
□	curriculum vitae including list of publications;
□	declaration of truthfulness and consent to the processing of personal data;
□	copy of an identity document.

The processing of personal data provided by applicants is carried out in compliance with the provisions of EU Regulation 27.04.2016 no. 679 (General Data Protection Regulation - GDPR).

Personal Data Processing
□	The undersigned declares to have read the information notice regarding the processing of personal data 
□	The undersigned authorizes the Data Controller and the Data Processor to process personal data under the terms specified in the above-mentioned information notice. 
Declaration of responsibility
□	The undersigned, pursuant to Articles 46 and 47 of Presidential Decree 445 of 28/12/2000, aware of the sanctions provided for by Articles 75 and 76 of the same decree and subsequent amendments and additions, certifies the truthfulness of the statements made in this application.

Date,
									Signature