ISCRIZIONE MASTER / MASTER REGISTRATION [2018-2019] Master Itinerante in Architettura per L'Archeologia NOME / NAME* COGNOME / SURNAME* LUOGO DI NASCITA / PLACE OF BIRTH* DATA DI NASCITA / DATE OF BIRTH* MM slash DD slash YYYY CODICE FISCALE / TAX CODE* GENERE / GENDER*Maschio / MaleFemmina / FemaleNAZIONALITA' / NATIONALITY INDIRIZZO DI RESIDENZA / ADDRESS* Address Secondary address Locality Province / state ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country EMAIL* TELEFONO / PHONE*UNIVERSITA' DI PROVENIENZA / UNIVERSITY* ANNO DI CORSO UNIVERSITARIO / YEAR UNIVERSITY COURSE DOMANDA DI ISCRIZIONE / APPLICATION FORM*Accepted file types: pdf, Max. file size: 200 MB.(Allegato A, ex Art. 11 oppure allegato B, ex Art. 12). Caricare il file in formato pdf. Appendix A, ex. Art. 11 or Appendix B, ex Art.12. Upload the application form PARTECIPAZIONE AL PREMIO PIRANESI 2017 / PARTECIPATION TO PIRANESI PRIZE 2017* SI NO RICONOSCIMENTO OTTENUTO*Piranesi PrizeFiaba PrizeCentenary PrizeSpecial mentionCertificate of partecipationDISTINTA DI VERSAMENTO / PAYMENT RECEIPT*Accepted file types: pdf, Max. file size: 200 MB.CARICA FOTO /UPLOAD ID PHOTO*Accepted file types: jpg, Max. file size: 1 MB.INTESTAZIONE FATTURA / INSERT DATA INVOICE*INSERIRE Nome Cognome, Indirizzo, Cap, C.F., P.IVAInformativa privacy* Acconsento / I agree Non acconsento / I don't agree
