Curs Acadèmic:



FACULTY/SCHOOL: NUMBER: /

(Reserved for the Campus Secretariat)

(Reserved for the Secretariat)

APPLICATION FOR ISSUANCE OF DOCTORAL DEGREE CERTIFICATE

|PERSONAL INFORMATION |

|Name: |First surname: |Second surname: |

|My identity card, NIE or passport number|Address (for written correspondence): |

|is: | |

|Postcode: |Town: |Fixed telephone:: |

|Mobile telephone: |URV e-mail address: |

|I STATE |

|That on: |I successfully completed the defence of my doctoral thesis at |

|I REQUEST |

|That the issuance procedure be initiated: |

| | |For my doctoral certificate and the European Supplement. |

| |

| | |For my doctoral degree certificate with the Industrial Doctorate distinction. |

| |

| | |For my doctoral degree certificate with the acknowledgement “This thesis has been jointly supervised by the University” on the |

| | |obverse ___________________________________________________________________________. |

| | | |

| | |For my doctoral degree certificate with the International Doctor distinction. |

| |

I have been informed that, once my request has been processed, the secretary's office of the Campus/Centre will provide me with a receipt for my degree certificate.

[place]_________________________, [date] __________________________________________

(signature)

|Documentation to be provided: |

| |

|Identity card, passport or NIE. |

|The originals of any other scanned documents that you have provided during your application. |

|A copy of the contract for the THESIS COMMUNICATION PROJECT (TDX), signed between the URV and the author. |

|The thesis in a single unprotected computer file in pdf format. It must be presented and deposited at the secretary's office in a digital format |

|(CD, pen drive, etc.) |

Rector of the Universitat Rovira i Virgili

DUTY TO INFORM: The URV is responsible for your data and processes them for the purpose of managing your academic transcript and organising your teaching and study, in compliance with its duty to provide a public service. Your data will only be shared with third parties if the URV is legally obliged to do so or if you subscribe to any of the services provided by third parties that are indicated during this procedure. You have the right to access, rectify, remove, request the transfer, oppose the handling and restrict the processing of your data. You can more detailed information on Data Protection on the website of the URV ().

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v.02/08/2018

Academic year:

URV.E14.01.00

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