APPLICANT’S PERSONAL INFORMATION
First name		
		
Family name		
		
Permanent address		
		
City		
		
State		
		
E-mail address		
		
Nationality		
		
Date of PhD award (or length of full time equivalent research experience)		
		
Duration of appointment as “Assegnista di ricerca” completed at any Italian University at the time of application for the present call (Law 240/2010 – indicate total no. of months, if any)		

 
GENERAL INFORMATION ABOUT THE PROJECT
Type of Action		
		
Proposal Acronym		
		
Proposal Title		
		
PANEL		
		
Duration of the project		
		
Proposed starting date		

 
INFORMATION ABOUT THE HOSTING DEPARTMENT
Hosting Department at the University of Padua (UNIPD)		
		
Supervisor at UNIPD		
		
Partner Organization (for Global Fellowships only)		
		
Supervisor at Partner Organization		

 
MSCA SEAL OF EXCELLENCE@UNIPD PARTICIPATION REQUIREMENTS
MSCA SEAL OF EXCELLENCE@UNIPD Grantees will be appointed through a research grant contract (Contratto di assegno per lo svolgimento di attività di ricerca di tipo b) under the provisions of Art. 22 of Law no. 240 dated 30 December 2010 (see Article 5 of the Call).
Please state if, at the time of this application,	
you hold an employment contract at the University of Padua (UNIPD)	
	No			Yes	Expected contract deadline		
				
you hold an employment contract at a private/public organization other than UNIPD	
	No			Yes	Expected contract deadline/permanent position		

 
APPLICANT’S SIGNATURE
Date		Signature