CALL NO. 15/2012 FOR APPLICATIONS FOR A RESEARCH FELLOWSHIP
DEADLINE FOR APPLICATIONS: midday, May 28, 2012
APPLICATION FORM FOR PARTICIPATION
To the Director of the CIMeC
I, THE UNDERSIGNED,
Surname
(women please state maiden name)
Name
province(1)
Place of birth
date of birth(2)
(foreign nationals please also state the country)
Tax code
residing in
(town and county/state)
(house number and street)
Province (1)
post code
country if other than Italy
Phone number
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


email address
agree to the processing of my personal data, in accordance with Leg. Decree no.196 of 30 th June 2003,
for the purposes of the present selection procedure.
attach a photocopy (3) of my identity card or other identity document which I will submit in person to
the examination offices (obligatory if the application is sent by post or delivered by a third party)
regarding publication of the results of the selection on the CIMeC website I, the undersigned,
(4)
:
agree to my name appearing
do not agree to my name appearing
Place and Date
__________________________
Signature
_________________________
Reserved for office use CIMeC administration
I declare that ___________________________________________, whose identity I have confirmed,
(document ______________________ no. _______________________) has signed in my presence.
Trento, date:___________________
Employee’s name: _____________________________
I, THE UNDERSIGNED,
having read the Call for applications no. 15/2012 for the award based on qualifications of 1
research fellowship at CIMeC, in respect of:
Scientific/disciplinary area
M-PSI/08 Clinical Psychology
Principal Investigator (Tutor): Dr. Nathan Weisz
Research title:
Brain-state dependent perception: implementation of MEG / EEG
real-time framework
Research goals:
The neural correlates of conscious perception have largely focussed
on brain activity starting with stimulus onset. However an increasing
amount of research demonstrates that different prestimulus brain
activity patterns may be associated with different poststimulus
conscious states. The overall goal of WIN2CON is to better
understand the role of ongoing brain activity (local as well as
interareal synchronization patterns) in how they shape conscious
perception and to explicitly incorporate these fluctuating states in a
wider framework for describing the neuronal basis of conscious
perception. The mid-term goal will be to control perception
experiments in the MEG and EEG setting using relevant patterns
identified from ongoing brain activity. The role of the research fellow
will be to implement and test real-time MEG / EEG framework at the
CIMeC. Apart from analysing features of ongoing brain activity in
real-time the system will need to have the capacity of controlling
stimulation softwares as well as the TMS system. The fellow will
profoundly test the real-time EEG / MEG framework using offline data
from previous experiments in order to set benchmarks. At tight
collaboration with the rest of the WIN2CON team is therefore
absolutely necessary. In the final year the fellow is expected to have
advanced the framework so far that first real experiments using
brain-state dependent stimulation are possible.
Duration of the fellowship:
3 years (presumably June 2012 – May 2015)
REQUEST
permission to apply for the above-mentioned fellowship, and to this end, aware that false
declarations are punishable by law under Article 76 of Presidential Decree no. 445 of 28th
December 2000 and that this Administration will carry out random checks on the accuracy of the
declarations made by candidates,
DECLARE
under my own responsibility and in accordance with Articles 46-47 of Presidential Decree
445/2000,
that I hold the following Research Doctorate
awarded by
date (2)
title of thesis
OR
that I have completed all requirements for the Ph.D in
title of thesis
and that I’ll obtain my PhD title prior to signing the contract;
that I have the appropriate scientific and professional experience required to carry out the research
described in article 1 of the call;
that I have excellent experience in MEG / EEG research (in particular brain oscillations and
connectivity);
that I have excellent programming experience (in particular in Matlab, C/C++ and Python) ;
that I have skills in conceptualizing and writing articles for peer-reviewed journals;
that I have an advanced level of competence in English;
that I am aware of the restrictions described in Article 7 of the Call for applications for this research
fellowship;
that I have never received a research award as per Article 22, Law 240/2010;
that I have previously received research awards as per Article 22, Law 240/2010 and, in particular,
I have been the recipient of1:
 an award for the duration of _____ months at (name of institution) ____________________,
beginning ____________ ending ____________ ;
 an award for the duration of _____ months at (name of institution) ____________________,
beginning ____________ ending ____________ ;
 an award for the duration of _____ months at (name of institution) ____________________,
beginning ____________ ending ____________ ;
that I have received a research award as per Article 2, Law 240/2010 for the purposes of
undertaking a research doctorate, and in particular:
 that I was enrolled on a doctoral research course in __________________________________
____________________ from ________ to __________ at (name of institution)
__________________________________,
 that the legal duration of the doctoral research course in ______________________________
____________________ is __________ years,
 that I have made use of an award for ___________ months for the purposes of following a
doctoral research course
that I am not under any similar contract for research activities at this or any other university;
that I do not enter into any of the following exclusion categories, being aware that under Article22,
Law 240/2010, the research fellowship:
 cannot be held by any permanent staff of universities, institutions and public bodies engaged
in research and experimentation, the National Agency for New Technologies, Energy and
Sustainable Economic Development (ENEA) and the Italian Space Agency (ASI), nor of
institutions which award an advanced specialised scientific degree equivalent to a research
doctorate under the terms of Article 74, paragraph 4, of Presidential Decree 382/1980;
 cannot be undertaken at the same time as a course of study for a bachelor’s degree, a
master’s degree, grant-supported doctoral research or medical specialisation, in Italy or
abroad, and that public sector employees must take unpaid leave;
1
Indicate the number of months for which the award was used and the name of the institution granting the award, e.g. University of
Trento; please provide details of each award, for example, if you have had two awards of 24 months each at the same institution
indicate these as two separate awards on two different lines.


cannot be held by spouses or relatives, up to the fourth degree, of faculty members of the
awarding institution, the Rector, the Director General or a member of the University
Administrative Council;
cannot be combined with other grants of any kind, with the exception of those awarded by
national or foreign institutions for the purposes of integrating the researcher’s activities with
work experience abroad;
that I wish correspondence relating to the selection to be sent to me at the following address and
that I will give due notice of any change of address. (5)
(town and county/state)
(house number and street)
post code
Province (1)
country if other than Italy
other name (if different from applicant’s own name) to which correspondence may be addressed

only for non-EU citizens or citizens from countries which do not have a freedom of movement agreement with the EU
that your immigration and visa (permesso di soggiorno) papers are current for (state reason
here)…………………… expiring on……………………….; such a visa is an autonomous
working permit which allows the possibility to sign freelance work contracts. Should the
current visa permit be for reasons other than autonomous work, to undertake to require its
conversion to a work permit (lavoro autonomo).
Or
(only for those who do not have a current visa permit – permesso di soggiorno)
to undertake, if winner of the selection, to require a self-employment entry visa.
To be attached to this form:
 Scientific/professional CV (signed and dated) providing evidence of possession of the skills
required to carry out the research;
 Any publications, certificates or other qualifications that may provide further evidence of the
candidate’s suitability for this research project (a list of qualifications and publications,
signed and dated, must be included with this application);
 Doctoral degree certificate (or official University confirmation of having met PhD
requirements);
 Photocopy of a valid identity document.
Date
___________________
Signature
___________________________________
_________________________
NOTES:
This form must be completed in BLOCK CAPITALS
(1) Enter the vehicle registration code of the province; for foreign countries enter EE
(2) Enter the date in the format DD MM YY
(3) Tick if submitting in person
(4) Tick the relevant box
(5) Complete only if different from residential address.
I, THE UNDERSIGNED, ____________________________
aware that false declarations are punishable by law under Article 76 of Presidential Decree
no. 445 of 28th December 2000, and that this Administration will carry out random checks on
the accuracy of the declarations made by candidates
DECLARE UNDER MY OWN RESPONSIBILITY
and in accordance with Articles 46-47 of Presidential Decree no. 445 of 28th December 2000
(“SELF-EXECUTED CERTIFICATE AND SELF-EXECUTED AFFIDAVIT”)
(Add Curriculum Vitae)
Date
__________________________
Signature
________________________________
List of documents and publications
I, THE UNDERSIGNED, ____________________________________
aware that false declarations are punishable by law under Article 76 of Presidential Decree no. 445 of
28th December 2000, and that this Administration will carry out random checks on the accuracy of the
declarations made by candidates
ATTACH THE DOCUMENTS AND PUBLICATIONS LISTED BELOW AND DECLARE THAT THE
ATTACHED DOCUMENTS ARE TRUE COPIES OF THE ORIGINALS (in accordance with Article 19 Presidential Decree no. 445, 28th December 2000.
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Date
__________________________
Signature
_______________________________
NOTE:
Continue on an extra sheet if necessary, attached it and indicate that you have done so in the above list.