Multimedia and Distance Learning System

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Prof. Annamaria Silvana de Rosa
European  Doctorate on Social Representations and Communication Research Center and Multimedia Lab
University of Rome "La Sapienza" - Faculty of Psychology 2
Piazza d'Ara Coeli, 1 - 00186 Rome -Italy
Tel. n. 0039 0669380814 - Fax n. 0039 0669294280
email: annamaria.derosa@uniroma1.it

After the application form has been filled in, you may confirm its electronic transmission by pressing the button "Send" at the end of this page. If the transmission is successful, an acknowledgement will be displayed. At this point, you can request to have your filled in application form on the screen, in order to print it, to sign it and to send it as above stated. If you forget to print the application form after the transmission, you can print an empty application form and fill in it by hand in order to send it by fax.

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APPLICANT

Last name
First name
Sex (M/F)
Birth date (mm-dd-yy)
Nationality
HOME ADDRESS
Tel. No.
Fax No.
E-mail
ADDRESS FOR CORRESPONDENCE (if different from above)
Tel. No.
Fax No.
E-mail
PLACE OF WORK (city and country)

Typology of application (please, click only one of the following options):

I am applying for the 7th International LAB Meeting:

as research trainee enrolled in the European  Doctorate on Social Representations and Communication

as new candidate of the European  Doctorate on Social Representations and Communication for 2007/2008 with no more than 4 years of research activity, since gaining a University Degree giving access to doctoral studies

as potential candidate of other doctoral program in Social Sciences with no more than 4 years of research activity, since gaining a University Degree giving access to doctoral studies or as doctoral research trainees who had not yet obtained a doctoral degree

as Experienced Participant with at least 4 years and less than 10 years of Research Experience - since gaining a University Degree giving access to doctoral studies (no more than 5 experienced participants will be admited, free of charge)

as Self-paying participant

QUALIFICATION First university or equivalent graduation

University Graduation date Discipline Qualification Grades

Brief curriculum vitae since graduation (relevant qualification):

Scientific publications (give the references of no more than 5, your best or most recent):

Knowledge of European Languages spoken level written level

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REFERENCES (please include a brief comment signed by the person below indicated):

Name and Institution of a person to whom reference may be made about your suitability to pursue the International LAB Meeting. The person should be a European Ph.D. National Tutor or SOCRATES Partner, or VINCI Partner, or So.Re.Com THEmatic NETwork Partner, or a Senior Member of the staff of the respective University, Polytechnic or College which you attend (e.g. Tutor of Doctoral Programme, Head of Department, Professor).

Name
University
Relation with applicant

Brief comments on benefit of participation from the Supervisor

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My current research activity is focused on the following topic:

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I wish to present my research project during the participant's thematic workshops (upon acceptance) with the following title:

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APPLICATION FOR MSCF-CT-2004-013264 FUNDING

Since I meet with the above indicated eligibility criteria, I would like to apply for MSCF-CT-2004-013264 funding

Since I don't meet the above indicated elegibility criteria, I will pay the amount of 1000 Euro for the scientific participation fee (not including travel, accomodation, and living expenses) as soon I will receive the letter of acceptance. The deadline and method of payment will be communicated with the letter of acceptance.