FORM A

APPLICATION FORM for the assignment of travel expenses contribution incurred by students for studying, training or thesis research AT THE UNIVERSITY OF SIDNEY (AUSTRALIA)

surname………………………………………  name  ………………………………………………
enrolment n°…………………………………………………….
telephone number …………………………………………………………
e-mail address   …………………………………………………………
degree course  …………………………………………………………
year of Course (first, second or third) ……………………………………………
n° of exams taken  within 1st MARCH 2015…………………………………………………………
n° of credits achieved within 1st MARCH 2015…………………………………………………..
Period of activity ouside the country  ………………………………………………………
Hosting institution/COUNTRY ……………………………………………………………………… 
activity (studyin, training, thesis research)……………………………………………………………..

TUTOR PROFESSOR OR SUPERVISOR ……………………………………………………………..

									STUDENT’S SIGNATURE
								………………………………………
Date:	…………………………………………	

Enclosures:

•	List of exams (or self certification)
•	Tutor professor’s/supervisor’s declaration (indicating kind and period of the activity to be carried out)

Application forms duly signed and enclosures have to be delivered at the Department of Land, Environment, Agriculture and Forestry - 2nd floor - 1st stecca  within:

-	24th April 2015, 13.00 am for the second semester at the Unviersity of Sidney (from July to November) 
-	30th October  2015, 13.00 am for the first semester at the University of Sidney (from March to June)

For further information: sara.ziggiotti@unipd.it