Personal data

First name

Last name

Born in (city, state or province, country)

Date of birth (For Safari date format: yyyy-mm-dd)

Address

Fiscal address (Resident in)

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City

Street address

Postal code

Is the Contact address (Domicile) the same as Fiscal address (Resident in)?

no yes

Degrees obtained from SISSA

I hereby ask

I hereby ask to be admitted as a member of SISSA Alumni Society

I accept

I am aware that the Board of Governors will consider my application to join the Society only after I send by email to secretariat@alumni.sissa.it a copy (front and back) of an identification document

I accept

I am aware that, if the Board of Governors accept my application, I become a member only after I pay the membership fee (if any)

I accept

I declare to have fully read, fully understood, and accept the Statute and the Standing Rules of the SISSA Alumni Society

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