(PLACE DATE) ……………… FOR THE ATTENTION OF THE TEACHING

(DATA OF THE ARTICLE AUTHOR 1) (PLACE AND DATE
(PLACE DATE) ……………… FOR THE ATTENTION OF THE TEACHING
(PUBLISHERS CONTACT DETAILS) ………………………… ……………………… ………………………… ………………………… (PLACE AND

ANLAGE IV1A (KONSORTIEN) ANLAGE V5A (HOCHSCHULEN) ZUSCHUSSVEREINBARUNG (PLACEMENT AGREEMENT)
……………………………………………… (PLACE AND DATE) …………………………………………………………………………………………………………… NAME AND SURNAME (NAMES
BRIEFING PAPER TO OVERVIEW & SCRUTINY COMMITTEE (PLACE) ON

Alla cortese attenzione del Consiglio Didattico della Facoltà di Medicina e Chirurgia dell'Università degli Studi di Pavia

(Place, Date) ………………



For the attention of the Teaching Council of the Harvey Medicine and Surgery Course

University of Pavia


Object: Request of authorisation for an international mobility period.

Student: (Last name, First name)
Year of Studies: …

Title of the Project: …. (Clinical training, research training in….)

With this letter, I am requesting the authorization for an international mobility period at the University of …………… , in… (city, Country), from………………… to……………………

 This project comes from a personal interest in improving my skills and knowledge in a foreign language, together with an interest in the academic and clinical aspects of the host Country. (modify as desired).

Prof…….. is the project Coordinator at Home Institution and supports my initiative.

OR

I don’t have any project Coordinator at Home Institution: I got directly in touch with the Host Institution.

The Responsible at the University of……………….., Prof/Mr…. accepted my project and confirmed I will be able to attend the desired clinical rotation/research activity.


The activity I will attend might correspond to ……… credits of “Clinical Cases …. Year” or to ……. credits of “attività formative in sovrannumero”.


At the end of the mobility period, I will submit a request of validation, attaching the final certificate released from the Host Partner.

Please find attached:

I thank you very much for your attention and look forward to hearing from you.
Kind regards.

Student’s signature


FORM APPLICANT’S DETAILS (PLACE) (DATE) NIP REGON
FORM NO 1 APPLICANT’S DATA (PLACE) (DATE)
FORM NO 21 ……………………………………………………………………………… ………………………… (PLACE AND DATE) ……………………………………………………………………………


Tags: teaching, (place, date), attention, ………………