PRE-REGISTRATION FORM

INTERNATIONAL SUMMER SCHOOL IN CONSERVATION OF HISTORICAL,

MONUMENTAL AND ARCHAEOLOGICAL SITES

University of Rome “Tor Vergata” - Department of Civil Engineering & Computer Science
July 22nd - August 4th, 2014

Pre-registration deadline: May 17th, 2014

Please send the pre-registration form by e-mail to summerschool-ch@uniroma2.it

PERSONAL DATA OF THE APPLICANT

NATIONALITY M F
FIRST NAME FAMILY NAME
PLACE OF BIRTH DATE OF BIRTH

CONTACT DETAILS

CURRENT ADDRESS
CABLE PHONE MOBILE PHONE
E-MAIL

EDUCATION (a graduation of a minimum of 3-years academic curriculum is required)

Degree Civil Engineering ( years) Degree Building Engineering ( years)

Degree Building-Architecture Engineering (Ingegneria Edile-Architettura ) ( years)
Degree Architecture ( years) Other: ( years)
NAME OF UNIVERSITY
FACULTY/DEPARTMENT
CITY STATE

LANGUAGE SKILLS

MOTHER TONGUE ENGLISH

Spoken Basic Good Fluently
Written Basic Good Fluently

My CV is attached.