ANNEX "A"

Application form
   (on plain paper)

To the Director
of the Department of Agriculture
University of Sassari
Viale Italia, 39
07100 Sassari

the undersigned_ __________________________________ born in ____________________________(province of ____)
on ____________________ and resident in _______________________________________________ (province of ___) address street_______________________ number_____  zip code _____________ Tax Code ______________________________,

asks to be admitted to participate in the public comparative procedure, based on qualifications only, announced by Decree of the Director D.D. n. ____/2023 prot. n. _____ dated ___/__/2023.
To this end, the undersigned declares, pursuant to articles 46 and 47 of the Presidential Decree no. 445/2000 and in awareness that anyone who makes false statements, drafts false deeds or uses them is punished under the penal code and special laws on the matter:

1) to be in possession of the ______________________________ citizenship
2) to enjoy civil and political rights (if not an Italian citizen, even in the country of belonging or origin);
3) to be in possession of the requirements, provided for in article 2 of the call letter A.
4) to have no criminal convictions and not to be aware of pending criminal proceedings or to have reported the following criminal convictions _________________ or to be aware of the following criminal proceedings in progress ___________________________________________________________________
5) to have served/to serve in public administrations or not to have served/not to serve in a public administration;
6) not to be, or to have been dismissed or exempt from employment in the public administration for persistent, insufficient performance, or declared forfeited from a state job for having produced false documents or vitiated by non-remediable invalidity;
7) to be physically fit for the job;
8) not to be in situations, even potential ones, of conflict of interest pursuant to current legislation
9)not to have a degree of kinship or affinity, up to the fourth degree inclusive, with the Rector, the General Manager or with a member of the University Board of Directors pursuant to art. 18, paragraph 1 of Law 240/2010 and art. 9 of the University Code of Ethics;
10) to have adequate knowledge of the Italian language (only for candidates of citizenship other than Italian);
11) possession of the following evaluable qualifications indicated in article 3 of the announcement:

•	________________________________
•	____________________________________
•	_________________________________

to elect his/her domicile for the purposes of the procedure in: city________________________________________ address street ___________________ n° _____ zip code _________ telephone number__________________, e-mail _____________________.
_the_ undersigned_ undertakes to promptly communicate any changes of address._the_ undersigned_ declares, under his personal responsibility, that what has been stated above is true and undertakes to prove it by submitting the prescribed documents within the terms and in the manner established in the notice.

_the_ undersigned_ attaches to this application:
a) documentation certifying academic, professional and evaluable qualifications required in this notice (Annex B);
b) photocopy of a valid identity document;
c) photocopy of the tax code;
d) curriculum vitae, in compliance with the European model in force, (attachment C).

_the_ undersigned_ also declares to be informed_ that, in compliance with the provisions of EU Regulation 2016/679, sensitive and judicial personal data are processed by the University of Sassari in accordance with current legislation.

Date ___________
The declarant
________________

ANNEX "B"

STATEMENTS IN LIEU OF CERTIFICATIONS
(art. 46 Presidential Decree 445/00)

SUBSTITUTE DECLARATIONS OF THE NOTIFY DEED
(art. 47 Presidential Decree 445/00 )

I the undersigned Surname__________________________Name_____________________________ Tax Code_________________ born in_______________(province_____) on_____________________ current residence in____________ province ______ address_______________________ zip code_______
Mobile number_______________
Email _______________

aware of the penal sanctions provided for by art. 76 of the Presidential Decree 445/00 for cases of false documents and false declarations

DECLARE

N.B. YOU ARE REQUIRED TO COMPLETE THE FORM IN ITS PART OR COLUMN

For the purposes of admission to the procedure (DD rep. n. ..../2023 prot. n. ..... of ../../2023)

to be in possession of the following admission requirements, set out in art. 2 of the announcement: 

•	Documented five-year experience in designing and facilitating social learning processes for developing innovative governance of water resources, through scientific papers published in academic journals.

Organization (name and address)	Position held and description of main tasks/responsibilities	
Period (mm/yy)	Total number of months
	
		from	to		

					

For the purposes of evaluating qualifications:
to be in possession of the following evaluable qualifications, provided for in art. 3 of the notice:

experience, exceeding the minimum 5-year requirement, in the design and facilitation of social learning processes for developing innovative governance of water resources, through scientific papers published in academic journals;

Organization (name and address)	Position held and description of main tasks/responsibilities	
Period (mm/yy)	Total number of months
	
		from	to		

					

relevant scientific publications (scientific publications in copy up to a maximum of 15):
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

The undersigned also declares to be informed that, in compliance with the provisions of EU Regulation 2016/679, sensitive and judicial personal data are processed by the University of Sassari in accordance with current legislation

Place and date
________________________

The declarant

         ________________
                                                                                                                          (signature)