ERASMUS MUNDUS PROGRAMME MOVER MOBILITY LOT 13 20122013

The Beneficiary

Student’s name:

Surname

ADDRESS

Country:

BIRTH DATE

PHONE

E-MAIL

Home University:

Host University.

_______________________________________________________________

_______________________________________________________________

Academic Year: _____/_____

Study field: ________________________

Subject Code

Subject /Course unit title

Credits/ ECTS

Total

Subject Code

Subject

Credits/ ECTS

Total

if necessary, continue the list on a separate sheet

Student’s signature:____________________________________ Date:____/____/____

HOME INSTITUTION

We confirm that the above proposed programme of study / learning agreement is approved.

Signature of the responsible person for Mobility at the Home University: ______________________________________________________ Data Date:____/____/____

HOST INSTITUTION

We confirm that the above proposed programme of study / learning agreement is approved.

Signature of the responsible person for Mobility at the Host University:

______________________________________________________ Data Date:____/____/____

<HOME INSTITUTION>

We confirm that the proposed programme of study/learning agreement is approved and all credits can be transferred back in the student’s course of study at the home university.

<HOST INSTITUTION>

Signed by the responsible for the Academic Recognition at the Home University)/

Signature of

 the Project Coordinator

 the Chairman of the Examination Committee:

 other Bodies (specify)………………………..

Date: _______/_____/____

Signature of the responsible person for the Mobility

at the Host University)

Date: _______/_____/____

Position:

Position:

Name:

Name:

_________________________________________

__________________________________________

Subject Code

Subject /Course unit title

(as indicated in the information package)

Deleted course unit

Added course unit

Credits/ ECTS

Total

Student’s signature:____________________________________ Date:____/____/____

HOME INSTITUTION

We confirm that the above-listed changes to the initially agreed programme of study / learning agreement are approved Signature of the responsible person for Mobility at the Home University: ______________________________________________________ Data Date:____/____/____

HOST INSTITUTION

We confirm that the above-listed changes to the initially agreed programme of study / learning agreement are approved.

Signature of the responsible person for Mobility at the Host University: ______________________________________________________ Data Date:____/____/____