Padua,

To the Coordinator 
PhD Program in Biomedical Sciences
Prof. Ornella Rossetto

I hereby declare that the PhD Student ………………………………………………….., will be supervised by myself and 
- ………………….………………………………………………………………as  co-supervisor, 
-……………………………………………………..……………………………as Advisor).
The PhD Student will carry out the research activities on (title of PhD program)  …………………………………………………………………………………………………………………….…………………..……..…………………………………………………………………..in my laboratory at (specify location or locations) …………………………………………………………………………………………………………

Faithfully
………………………………………………

(supervisor)
………………………………………………
(PhD Student)