University of Sassari Department of Economics and Woody Plant Ecosystems (DESA) You are invited to respect the deadline 14 AUGUST 2009 for returning this form APPLICATION FORM Academic Year 2008/09 SUMMER SCHOOL ON “CLIMATE CHANGE AND AGRICULTURE” Alghero, Sardinia - Italy 14-18 September 2009 PERSONAL DETAILS NAME and SURNAME DATE AND PLACE OF BIRTH NATIONALITY M F SEX (M/F) PERMANENT ADDRESS TEL. N° and MOBILE N° (include international dialling code) FAX N° (include international dialling code) E-MAIL If student HOME UNIVERSITY DATA NAME AND ADDRESS Application form SUMMER SCHOOL ON “CLIMATE CHANGE AND AGRICULTURE” Alghero, Sardinia - Italy 14-18 September 2009 1 University of Sassari Department of Economics and Woody Plant Ecosystems (DESA) FACULTY DEGREE COURSE FIELD OF STUDY LANGUAGE COMPETENCIES I declare to have an adequate knowledge of English THIS FORM, FILLED IN AND SIGNED, MUST BE RETURNED BOTH BY MAIL AND ORDINARY MAIL TO: E-MAIL: [email protected] mail Università degli Studi di Sassari Dipartimento di Economia e Sistemi Arborei DESA Via E. De Nicola 9 07100 Sassari I authorize the processing of my personal data in compliance with the Italian Data Protection Law in force (D.Lgs. 196/2003). YES NO Date:_________________ Signature: :_______________________________ Application form SUMMER SCHOOL ON “CLIMATE CHANGE AND AGRICULTURE” Alghero, Sardinia - Italy 14-18 September 2009 2