Mobility Agreement Staff Mobility For Teaching Planned period of the teaching activity: from [day/month/year] till [day/month/year] Duration (days) excluding travel days: – …………………. The teaching staff member Last name (s) First name (s) Seniority Nationality Sex [M/F] Academic year 2016/2017 E-mail The Sending Institution/Enterprise Name Technische Universität Chemnitz Erasmus code D CHEMNIT01 Faculty/Department (if applicable) Address Str. D. Nationen 62, Country/ Germany / DE Chemnitz Country code Contact person Oliver Sachs, Contact person . tu-chemnitz.de name and position Erasmus+ e-mail / phone Coordinator +49 (0)371 531 37972 Type of enterprise: - Size of enterprise - NACE code (if applicable) [<250 employees (if applicable) >250 employees] The Receiving Institution Name Faculty/Department Erasmus code (if applicable) Address Country/ Country code Contact person Contact person name and position e-mail / phone For guidelines, please look at the end on page 3. Section to be completed BEFORE THE MOBILITY
Mobility Agreement Staff Mobility For Teaching Planned period of the teaching activity: from [day/month/year] till [day/month/year] Duration (days) – excluding travel days: …………………. The teaching staff member Last name (s) First name (s) Seniority Nationality Sex [M/F] Academic year 2016/2017 E-mail The Sending Institution/Enterprise Name Technische Universität Chemnitz Erasmus code (if applicable) D CHEMNIT01 Faculty/Department Address Str. D. Nationen 62, Chemnitz Country/ Country code Germany / DE Contact person name and position Oliver Sachs, Erasmus+ Coordinator Contact person e-mail / phone . tu-chemnitz.de +49 (0)371 531 37972 Type of enterprise: NACE code (if applicable) - Size of enterprise (if applicable) - [<250 employees >250 employees] The Receiving Institution Name Faculty/Department Erasmus code (if applicable) Address Country/ Country code Contact person name and position Contact person e-mail / phone For guidelines, please look at the end on page 3. Section to be completed BEFORE THE MOBILITY