MIPET Registration Form

Your Personal Data

Name

Family Name

Birth Place

Birth Date

Citizenship

Gender

ID Document number and issue location

Current Residence

Country

City

ZIP/Postal Code

Street & Building

Contacts

Phone

Email

Skype

Your Education I declare to posses the following states and titles in compliance with art.46 of DPR 28 December 2000 n.445 related to declarations substitutive of certificate: High School

To have the following High School Degree

High School Name, City & Country

High School Completion Date

High School Grade obtained and Maximum Possible Grade/

University

To have the obtained the Following University Degree

Type of Degree (ex. MS, BS)

University Name, City & Country

University Completion Date

University Grade obtained and Maximum Possible Grade/

Duration of the Degree in term of legal years

Number of Scholastic Years required to be admitted to the course

Other Other University Degree Please specify Subject, Type and Class

Survey How you was informed of MIPET:

Documentation Hereafter you can upload scanned versions of your documents. It is possible to upload single document of each type, not larger than 1MB. The files will be uploaded when you press Submit button. Curriculum vitae/Resume. The file must be in PDF, DOC, DOCX or ODT format Photocopy of ID Card. The file must be in JPEG, PND, PDF, DOC, DOCX or ODT format University Degree Certificate Translated and Certified by Italian Embassy or Consulate - Please note that this document could be provided even after the Completion of the Selection Process in case of successful enrollment in the MIPET Master Program. The file must be in PDF, DOC, DOCX or ODT format Photo in JPEG or PNG format

Already uploaded files

Authorization

I hereby Confirm and Certify my Statements

I request to be admitted to Master of II Level in Master Industrial Plant Engineering and Technologies, MIPET

I certify here to be aware of the penal punitions and fees in case of false declaration within this demand as regulated by Italian Law at art.76 DPR 28 December 2000 n445 related to false in public declarations

I authorize DIME University of Genoa to use all these data in conformity with Italian regulation for the MIPET application

Next Steps When press the Submit button below, the form will be checked, and if all fields are compiled, you will be shown a code which could be used with your email address to check status of your application. Be sure to remember both code and email address that you used.