WAIVER FORM
TO:
The CAI of the Department ______________________________________________
The International Cooperation Unit (send in pdf format to cooperations@unipi.it) 

I, the undersigned____________________________________________________________________
born in___________________________ on _________________ UNIPI id number ______________
enrolled in the BA/MS Programme in ___________________________________________________
selected for the grant allocation referred to in the “Call for financial grants for mobility at partner universities for the issue of double degrees - year 2026” with a grant financial gross amount of 5.000,00 euro, 
Declare
•	the grant allocation waiver, with the following:  ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Undertake

•	to promptly notify the waiver to the foreign receiving institution;
•	to totally refund the allocated contribution in the event of failure to obtain the double or joint degree.

Signature and date 

__________________________________________________________________________________