Module: front | rear

The form to be filled is made of a single sheet. The first side, contains the student's anagraphic data (look at zones 1A, 1B, 2 and 3), the degree course you're attending (zone 4) and a confirmation area (zone 5).

1A/1B: This is the first part of the form, reported as "Personal Information" and contains your anagraphic data. First of all you have to write your first name and your surname. The following first address (1A) refers to your usual studying location, the second address (1B) refers to your residential address. If you study where your residence is, part 1A can be left blank.

Note: remember to circle with a pen your last name to make it more evident.

2: In this field of the form you could write your e-mail address.
Note: If you're subscribing through our Student Branch, this e-mail address will be the one used to send you the informations on our Student Branch activities; the above e-mail adddress will never be shared with third parties and should be modified or cancelled from our mailing-list simply sending an e-mail to our address: ieeesb@dei.unipd.it.

3: The third part contains your birth date an sex. The following field asks what address you prefer to receive the mailings, choose your studying o residential location. If left blank, the default address is the first one. A further question asks if you are yet an IEEE member, if not, cross the NO option.

4: The "Educational Information" section should report your educational organization address; as example:
University: University of Padova
School or College: D.E.I.
Street Address: via Gradenigo 6/A
City: Padova, State/Province: PD
Country: Italy, Postal Code: 35100
followed by your graduating title: Degree Title Expected: Engineer
and your graduation date: Expected Graduation Date: month/year).
In the field "Program/Course of Study" you can report your "specialization": (Electrical Eng., Computer Eng., Electronics Eng., etc.).
After that you have to cross your study duration in years (2-3 or 4-5), your "specialization" and report other achieved graduations.

5: In this last part of the front form, evidenced as "Endorsement and signature of appicant" you have to sign in the field Signature and place the date of subscription in the field Date.