Application Form - Master of Science in Space Engineering

Before filling in the application, read carefully the instructions on this page!
1. PERSONAL DATA
Name*
First Middle Last
Gender*
Date of birth*
Birthplace - City*
State - Province
Country*
Country (or countries) of citizenship*
Passport number (or other valid I.D.)*
In the past, did you ever apply to study at the University of Pisa?*
- Yes
- No
If yes, what year?
2. CONTACT INFORMATION

Current

Current Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Current Main Phone Number*
Current Alternative Phone Number
Current Email*
Current mailing address valid until:

Permanent

Permanent Mailing Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Permanent Main Phone Number
Permanent Alternative Phone Number
Permanent Email
Permanent mailing address valid until:

3. EDUCATION
List all colleges and universities attended, including those in which you are currently enrolled.

Institution No. 1

Institution Name*
Dates of attendance*
Enter the beginning and end (or expected end) dates of attendance; e.g., "September 2016 to June 2020"
Degree level awarded or expected*
e.g. BSc, BTech, MSc, MEng, etc. - Please specify your major: e.g., "BSc in Aerospace Engineering"
Date (or expected date) of award*
GPA*
Enter your actual or expected Grade Point Average

Institution No. 2

Institution Name
Dates of attendance
Enter the beginning and end (or expected end) dates of attendance; e.g., "September 2020 to June 2024"
Degree level awarded or expected
e.g. BSc, BTech, MSc, MEng, etc. - Please specificy your major: e.g., "BSc in Aerospace Engineering"
Date (or expected date) of award
GPA
Enter your actual or expected Grade Point Average

Institution No. 3

Institution Name
Dates of attendance
Enter the beginning and end (or expected end) dates of attendance; e.g., "September 2016 to June 2020"
Degree level awarded or expected
e.g. BSc, BTech, MSc, MEng, etc. - Please specificy your major: e.g., "BSc in Aerospace Engineering"
Date (or expected date) of award
GPA
Enter your actual or expected Grade Point Average

4. TEST SCORES
If you have taken graduate record examination tests, such as the GRE general test or GRE subject tests, please provide the relevant details below: type of test, date of test, marks received
Test No. 1
Test No. 2
Test No. 3
5. LANGUAGE SKILLS
Describe your language skills using the following scale: 1 = Basic; 2 = Intermediate; 3 = Fluent; NL = Native Language

Language No. 1

Language No. 2

Language No. 3

Language tests
If you have taken English language tests, such as TOEFL/TSE/TWE/IELTS, please provide details below: type of test, date of test, marks received
6. FUNDING, HONORS, AWARDS
Funding
Specify which scholarships, fellowships, grants, etc. (if any) you plan to use to support your studies at University of Pisa. For each, specify the funding source and whether you have applied for it or if you have already been granted support.
Honors, awards
Describe any honors, awards, prizes you have received or are going to receive.

Signature*
By entering my full name in the field below, I declare that the information on this form is true, correct, and complete. The University of Pisa has my permission to verify the information here reported by obtaining documentation as needed. WARNING: Providing false information may result in University of Pisa revoking its initial decision to enroll the student.

1. PERSONAL DATA