Annex 1

To the Rector 
Università degli studi di Modena e Reggio Emilia

APPLICATION FORM 
VISITING PROFESSOR a.y.2024/25

Unimore Master’s Degree /PhD Course in which the teaching activity will be performed		
Unimore Department/s in charge of the above-mentioned courses		
Supervisor	Prof. …….email	

Visiting Professor Data: 
Name		
Surname		
Place and date of birth		
Nationality		
Address		
Country		
E-mail		
Home Institution		
Department/Faculty		

Position	⁭ Full professor          

⁭ Associate professor  

⁭ Researcher                   	

Typology of Proposed Visiting Professorship 
	
⁭ Short-Term VP          

⁭ Long-Term VP  

⁭ Full Term 	
Brief summary of the teaching activity to be carried out	Fill in
(Please consider this section as a brief summary.
A complete teaching activity proposal must be attached to the present application form) 

⁭ Seminars          

⁭ Modules  

⁭ Official Unimore’s single course*               
	
Proposed length of stay	a.y. 2024/25

□ 1 month
□ 2 months
□ 3 months
□ Full semester (only for VPs Full term in charge of a single course*)

From…………………to…………………….

Documents to be mandatorily annexed:
-	Curriculum Vitae of the candidate including a list of the 5 most important publications/monographs within the last 5 years, and/or a list of the candidate’s speaking engagements at international conferences;
-	Proposal of the teaching activities. Content: title, full description, duration in hours, credits, teaching language, etc.
-	Delibera di Dipartimento (Annex 2, to be attached by the involved Department/s)
-	Personal data processing authorization (Annex 3)

Date, 

Signature of the Applicant (Visiting Professor)
Signature of the Director/s of the Department/s in charge of the teaching activity to be performed

*Single Course: an official single course, with a one-semester duration, within a Unimore’s Degree Programme