ࡱ> [%bjbj$$BFkiFki33$3$$$$$$$8$</%T$N&&&&&9Pk99 $V2-$9889923$3$&&_:::93$&3$R&( :9 ::FJ$"&0[z7:ZTu0d:(B$T 99:9999922:9999999999999999Y ":MODULO CANDIDATURA Al Direttore dellAccademia Nazionale dArte Drammatica Silvio dAmico, via Vincenzo Bellini 16 Roma Il/la sottoscritto/anato/a aProv.ilcodice fiscalee residente aProv.CAPvian.telefonoe-mail Chiede di essere ammesso a partecipare al concorso pubblico, per titoli ed esami, per la copertura a tempo indeterminato di n. 1 posto per il profilo di Docente di prima fascia per linsegnamento di ADRFV010 - Training fisico. Consapevole che le dichiarazioni mendaci sono punite ai sensi del codice penale e delle leggi speciali in materia e, altres, consapevole della decadenza da eventuali benefici conseguenti al provvedimento emanato sulla base della dichiarazione non veritiera, dichiara sotto la propria responsabilit: 1) di essere nato/a aProv.ilcodice fiscale 2)di essere cittadino/a 3)se cittadino/a italiano/a: di essere iscritto/a nelle liste elettorali del Comune di:di non essere iscritto/a nelle liste elettorali per i seguenti motivi: 4)se cittadino/a di uno degli Stati membri dellUnione Europea: di godere dei diritti civili e politici anche nello Stato di appartenenza o di provenienza;di non godere dei diritti civili e politici per i seguenti motivi: 5)se cittadino/a di Paesi Terzi: di essere cittadino/a di Paesi Terzi ai sensi dellart. 38 D.Lgs 165/01 e ss.mm. con il seguente permesso di soggiorno: rilasciato dallautorit competente  in dataovvero di essere nella condizione di % rifugiato % titolare di protezione sussidiaria;6)se cittadino/a di uno degli Stati membri dell Unione Europea o Paesi Terzi:di avere adeguata conoscenza della lingua italiana % SI % NO;7)di non aver riportato condanne penali n di avere procedimenti penali e disciplinari pendenti;di avere riportato le seguenti condanne penali e/o di avere i seguenti procedimenti penali e disciplinari pendenti: 8)di non essere stato/a destituito/a o dispensato/a dellimpiego presso una Pubblica Amministrazione per persistente insufficiente rendimento, ovvero di non essere stato/a dichiarato/a decaduto/a da un impiego statale, ai sensi dellart. 127, primo comma, lettera d) del D.P.R. n. 3 del 10/01/1957; 9) di eleggere ai fini della presente procedura il proprio recapito al seguente indirizzo:ComuneProv.CAPvian.telefono/cellularee-mail/PEC 10)di aver letto il bando del concorso pubblico, per titoli ed esami, per la copertura a tempo indeterminato di n. 1 posto per il profilo di Docente di prima fascia per linsegnamento di ADRFV010 - Training fisico e di accettarne tutte le condizioni. Il/la sottoscritto/a consapevole della veridicit delle attestazioni contenute nella presente domanda ed a conoscenza delle sanzioni penali, di cui allart. 76 del D.P.R. 28/12/2000 n. 445, in caso di dichiarazioni mendaci e della decadenza dei benefici eventualmente conseguenti al provvedimento emanato sulla base di dichiarazioni non veritiere, di cui allart. 75 del D.P.R. del 28/12/2000. Il/la sottoscritto/a dichiara di essere informato/a, ai sensi e per gli effetti di cui al Regolamento Europeo n. 679/2016, che i dati personali raccolti saranno trattati, anche con strumenti informatici, esclusivamente nellambito riportato nel bando di concorso. Il/La sottoscritto/a allega alla presente domanda: copia di un documento di riconoscimento in corso di validit (fronte/retro e ben leggibile); copia del codice fiscale (o codice di identificazione personale); dichiarazione sostitutiva di certificazione con firma autografa attestante il possesso dei titoli di studio e di servizio; dichiarazione sostitutiva di certificazione con firma autografa attestante il possesso dei titoli artistico culturali e professionali curriculum vitae di tipo europeo con profilo artistico-professionale e attivit di ricerca pertinente alla disciplina dellincarico di insegnamento cui si aspira; i curricula presentati in formato differente da quello di tipo europeo non saranno ritenuti valutabili; (luogo e data)(firma del dichiarante)      PAGE \* MERGEFORMAT1   Accademia Nazionale dArte Drammatica Silvio dAmico Via Vincenzo Bellini, 16 - 00198 ROMA Tel 06.8543680/2505 Fax 06.91502793 C.F. 80218690586 HYPERLINK "http://www.accademiasilviodamico.it/" \hwww.accademiasilviodamico.it Accademia Nazionale dArte Drammatica Silvio dAmico Via Vincenzo Bellini, 16 - 00198 ROMA Tel 06.8543680/2505 Fax 06.91502793 C.F. 80218690586 HYPERLINK "http://www.accademiasilviodamico.it/" \hwww.accademiasilviodamico.it %YZ[rsxyz hh!hh7BLB*OJQJ^Jphh7BLB*OJQJ^JphhB*OJQJ^Jph!hhB*OJQJ^Jph,hBQh5B*CJ OJQJ^JaJ phDr,hBQhj5B*CJ OJQJ^JaJ phDr7[syz\ykd$$Ifl0% t0%44 layt: $$Ifa$gdm$ $a$gd7BLm$ $a$gdm$ $a$gdm$ Qkd$$Ifl\!%R t0%44 layt $$Ifa$gdm$_QQQQ $$Ifa$gdm$kd$$Ifl\6 %1 t0%44 layt_QQQQQQ $$Ifa$gdm$kd$$Ifl\!% t0%44 layt9+++ $$Ifa$gdm$kdT$$Iflֈ6 !%1+ t0%44 layt    QHHHHH $a$gdm$kd $$Ifl\K%t LV t0%44 layt: $$Ifa$gdm$ - y r |         ! 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