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Homepage
Chi siamo
Advisory Board
Comitato Direttivo
Consiglio Scientifico
Staff UCBM Academy
Offerta formativa
Master di I e II livello
Corsi di Perfezionamento
Formazione Permanente
Corsi ECM
Executive Program
Formazione per le aziende
Simulation Center
Team Coaching e Intelligenza Emotiva
International
News
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International Short Program | Pre-registration form
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Step
1
of 10
SECTION 1 – Type of Application
Please select your category:
*
Erasmus+ Staff Mobility
Students / Professionals / Researchers / External Staff
Next
SECTION 2 – Personal Information
Name
*
Nome
Cognome
Role
*
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University Staff
Student
PhD
Professor
Researcher
Professional
Other
If “Other”, please specify
*
University / Company / Institution of affiliation
*
Email address
*
Phone number (including country code)
*
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Date of birth
*
Age
*
Gender
*
Female
Male
Prefer not to say
Codice Fiscale / National Insurance Number
*
Nationality
*
Country of residence
*
Full address
*
(Street name and number, city, postal code)
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SECTION 4 – Academic / Professional Status
Which of the following best describes you?
*
University Student
PhD
Post-doc
Researcher
Professional
Other
If “Other”, please specify
*
If you are a student, please indicate:
Course of study
*
Year
*
University
*
Institutional affiliation
Are you a UCBM student?
*
Yes
No
Are you from a UCBM Partner University?
*
Yes
No
If yes, please specify
*
Mobility information
Are you currently studying or working outside Italy?
*
Yes
No
If yes, where?
*
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Language Personal Declaration
SECTION 5 – Language & Skills
What is your level of English?
*
Upper-intermediate (B2)
Advanced (C1)
Proficient (C2)
Native Speaker
I don’t know
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SECTION 6 – How did you hear about the International Week?
How did you hear about the International Week?
*
Personal recommendation
Università Campus Bio-Medico di Roma (UCBM)
Partner University
Social media
LinkedIn
Other
If other, please specify
*
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SECTION 7 – Required Documents (Download & Upload)
Download Erasmus Staff Agreement
Click here and Download Erasmus Staff Agreement
Upload completed and signed Erasmus Staff Agreement (PDF only)
*
Drag & Drop Files,
Choose Files to Upload
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SECTION 8 – Privacy & Consents (GDPR)
I declare that I have read and understood the privacy notice regarding the processing of personal data pursuant to Article 13 of the GDPR:*
*
I declare that I have read and understood the privacy notice regarding the processing of personal data pursuant to Article 13 of the GDPR:
Read the privacy policy
I consent to the production and publication of photographs, videos and audio-video recordings during the International Week for institutional communication purposes.
I consent to the production and publication of photographs, videos and audio-video recordings during the International Week for institutional communication purposes.
I consent to receive promotional and informational communications related to UCBM educational activities
I consent to receive promotional and informational communications related to UCBM educational activities
I consent to the processing of my personal data for profiling purposes in order to receive personalized communications
I consent to the processing of my personal data for profiling purposes in order to receive personalized communications
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SECTION 9 – Image Rights Waiver
Please read the Waiver and Transfer of Image Usage Rights and select one option
*
I consent
I do not consent
Waiver and Transfer of Image Usage Rights
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SECTION 10 – Final Declaration
I confirm that the information provided is accurate and complete.
*
I confirm that the information provided is accurate and complete.
I understand that this is a pre-registration only and that participation will be confirmed upon payment of the registration fee at a later stage.
*
I understand that this is a pre-registration only and that participation will be confirmed upon payment of the registration fee at a later stage.
Submit Pre-Registration
