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(Encl. no. 1)
Selection for recruitment N°6/2016 Stazione Zoologica Anton Dohrn Villa Comunale - 80121 Napoli
The undersigned ________________________________ born in _________________________________________
on __________ and resident in _______________________________________________________________________
Street ____________________________________________________________ n. ________ Zip Code ______________
asks to participate in the selection based on examination of qualifications and interview for the recruitment of N° 1 Technologist - III Professional Level with a fixed-term contract.
For this purpose, in accordance with artt. 46 e 47 of the Decree of the President of the Republic n. 445/2000 and subsequent amendments and additions and aware of the criminal liability provided for by article 76 of the same Decree of the President of the Republic for the hypothesis of falsification of documents and false statements, hereby declares, under his/her own responsibility:
- to be a/an ______________________________ citizen (indicate the nationality);
- to be registered to vote in the town of _________________________________________, if not state the reasons for the non registration or cancellation from such lists (the declaration is only for candidates having an Italian citizenship);
- that I have never been convicted of criminal offences and do not have any pending criminal proceedings or that I have reported the following sentences: _________________________________________________________________
(indicate the date of the order and the authority that issued it even if amnesty, pardon or judicial amnesty/pardon have been granted and penal measures pending in Italy and abroad, the statement needs to be made even in the absence of criminal convictions and of criminal proceedings);
- to possess the following educational qualifications ________________________________________ obtained on _______________________ (indicate day, month and year) at _______________________________________________;
- to possess the requirements as in article 2 point c);
- to possess the requirements as in article 2 point d);
- to possess the requirements as in article 2 point e);
- to have the knowledge as in article 2 point f);
- to have not worked in any public administration or to have worked and provided the following services to any public administration (specify periods of employment and the profile and the level possessed, as well as the possible causes of the conclusion of previous employment relationships ____________________________________________ ;
- of not having been removed or relieved from the work in a public administration or revoked by a state employment (if the contrary specify the reasons for the measure of dismissal, dispensation or forfeiture, the declaration must be made even in the absence of reports of public employment): ______________________________________________;
- to have rights to enjoy of the reserve in favor of military volunteers of the Armed Forces, dismissed without demerit, according to art. 1014, comma 3 and art. 678, comma 9 of the Legislative Decree 15/03/2010, n. 66, as _____________________________________________________________________________________;
- to possess the following preferably equal merit qualifications of Article 5 of the Decree of the President of the Republic n. 487/94: _______________________________________;
The undersigned _______________________________________ declares to have read the selection for recruitment and agrees with all the conditions set.
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The undersigned _______________________________________ asks that any communication regarding this recruitment will be sent to the following address, informing of any possible future variation and accepting that the Stazione Zoologica Anton Dohrn does not assume any responsibility in the event of unavailability of the addressee.
Address or PEC of the applicant ________________________________________________________________________
Ordinary email address (only for foreigners) ______________________________________________________________
Applicants whose citizenship is different from Italian must also declare:
- To benefit civil and political rights in the state of belonging or provenance, or the reasons for the loss of the benefit of the rights.
The undersigned also declares: _________________________________________________________________
The undersigned expresses his/her approval that the personal data given can be treated, in respect of the legislative decree June 30, 2003 n. 196, for all matters related to this procedure.
Together with the application form the documents required, as in Article 5 of the selection of recruitment, are hereby attached.
Date ______________ Signature ________________
