ENROLLMENT IN THE
INTERNATIONAL UNIVERSITY MASTER

PERSONAL DATA

* mandatory data
Name (*)

Surname (*)

Address (*)

Gender (*)
MF

ZIP Code(*)

Town (*)

Email (*)

Phone (*)

Country (*)
—Please choose an option—AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamas, TheBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurmaBurundiCambodiaCameroonCanadaCabo VerdeCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCote d'IvoireCroatiaCubaCuracaoCyprusCzechiaDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamYemenZambiaZimbabwe

I DECLARE

1. that I have the following qualification:
   

2. that the information and data provided and any attached documentation are authentic

3. and that I will take responsibility for communicating any changes regarding address, telephone number, and e-mail address

COURSE SUBJECT TO ENROLLMENT

INTERNATIONAL UNIVERSITY MASTER OF ITALIAN SCHOOL IMPLANTOLOGY

Complete Master Course (10 MODULES)OPEN DAY MASTER - MODULE No.2 - April 14-15, 2023OPEN DAY MASTER - MODULE No.5 - July 7-8, 2023OPEN DAY MASTER - MODULES No.2 + No.5

PROFILE

Degree achieved (*)

Include name, discipline, institution attended, address, country, academic year, and date of graduation

RELEASE OF CONSENT

International University for Peace
Italian privacy law - Legislative decree n. 196: I authorize the processing of my personal data exclusively for circulation within the International University for Peace of Rome for academic and informational purposes only (through NSI S.r.l.), according to legislative decree n. 196/2003, date 06/30/2003. I also authorize the International University for Peace of Rome to communicate with me using the previous contacts provided. Details are available in Privacy Policy of the University for Peace - Rome.

NSI S.r.l.
I declare that I have read the Privacy Policy of NSI S.r.l. Reg. (EU) 2016/679 and Legislative Decree no. 196 of 2003 (*)

The undersigned, having acquired all the information about the processing of their personal data that NSI Srl, as Data Controller carries out, hereby expresses their specific and distinct consent according to art. 23 and 130 of the Privacy Code and art. 7 GDPR, to the processing of their data for the following Marketing Purposes):

Sending advertising communications on products or services offered by the Data Controller by email

Sending advertising communications on products or services offered by the Data Controller by phone

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