To the Rector of University of Florence

Stamp
duty
€ 10,33
To the Rector of University of Florence
Segreteria Amministrativa Post-Laurea
Via Gino Capponi, 16/r
50121 FIRENZE
APPLICATION FOR THE INTERNATIONAL MASTER PROGRAM (M. Sc)
on DESIGN and HEALTH – 2003/2004
Organized by
Inter-universtity Research Center TESIS, University of Florence, , Italy
Royal Institute of Technology, KTH Syd, Stockholm, Sweden
PERSONAL DETAILS (write in capitals, please)
Surname or Family name First and others name Male/Female
Date of birth City of birth Country of birth
City of abode
Country of abode
Street name Number Post Code
Address for correspondance if different
Daytime telephone E-mail Fax
ENGLISH LANGUAGE PROFICIENCY (please include copies in the final
application)
My native (first) language is English
I have taken a university degree course in English
I have taken the TOEFL test Year : Total score:
I plan to take the TOEFL test
Place and date:
I have other proficiency in English
ACADEMIC QUALIFICATIONS
Please note. All applicants must enclose in the final application a translation of their academic records,
authenticated or certified by the Italian diplomatic or consular Authority. All applicants must also enclose

a transcript of their academic records, giving their marks or grades in each subject in eah year of their
course and the title of the degree thesis.
University Attended Date from Date to Qualification: give titles, subject Date awarded or
and classification or grade to be awarded
OTHER QUALIFICATIONS (academic and/or professional)
Please give nature, subject awarded and dates awarded
PUBLICATIONS
Please include copies in the final application.
RELEVANT WORK EXPERIENCE
Please give details of any posts you have held, with dates and names of employers, incuding present
post, if any. (Attach a separate sheet, if necessary)
FINANCIAL ARRANGEMENTS
Please note. To cover the living expenses for one person in Italy you need approximately US $ 1000 per
month; in Sweden you need approximately US $ 800 per month.
How will your fees be financed? Overseas Government Employer

Research Council Self-payer Other
Sponsor
Address
Contact name
Telephone
E-mail (or fax)
DOCUMENTS ATTACHED TO THE APPLICATION (in the final application)
1-
2-
3-
4-
5-
SIGNATURE OF APPLICANT
DATE