Date of Last name(s) First name(s) birth Nationality1 Sex [M/F] Study cycle2 Field of education3 Student Bachelor First – Cycle (EQF Level 6) Erasmus Faculty/ code4 (if Name Department applicable) Address Country Contact person name5; email; phone Sending Campus Badajoz and Mérida: Ana Santiago Avd. Institution Universidad Campus and Plasencia: Verónica E Universidad de Spain Monge BADAJOZ01 Extremadura Email: erasmusoutgoing@unex.es Cáceres Phones: +34 924289373/927257016 Erasmus Faculty/ Name code (if Address Country Contact person name; email; phone Receiving Department applicable) Institution Before the mobility Study Programme at the Receiving Institution Planned period of the mobility: from [month/year] to [month/year]………….. ……………. Semester Number of ECTS credits (or Table A Component6 Component title at the Receiving Institution [e.g. equivalent)8 to be awarded by Before the code (as indicated in the course catalogue7) autumn/spring; the Receiving Institution upon mobility (if any) term] successful completion Total: … Web link to the course catalogue at the Receiving Institution describing the learning outcomes: [web link to the relevant information] The of language competence9 in ________ [indicate here the main language of instruction] that the student already has or agrees to acquire by the start of the study period is: A1 A2 B1 B2 C1 C2 Native speaker Recognition at the Sending Institution
Student Last name(s) First name(s) Date of birth Nationality1 Sex [M/F] Study cycle2 Field of education3 Bachelor – First Cycle (EQF Level 6) Sending Institution Name Faculty/ Department Erasmus code4 (if applicable) Address Country Contact person name5; email; phone Universidad de Extremadura E BADAJOZ01 Avd. Universidad Spain Campus Badajoz and Mérida: Ana Santiago Campus Cáceres and Plasencia: Verónica Monge Email: erasmusoutgoing@unex.es Phones: +34 924289373/927257016 Receiving Institution Name Faculty/ Department Erasmus code (if applicable) Address Country Contact person name; email; phone Before the mobility Study Programme at the Receiving Institution Planned period of the mobility: from [month/year] ……………. to [month/year]………….. Table A Before the mobility Component6 code (if any) Component title at the Receiving Institution (as indicated in the course catalogue7) Semester [e.g. autumn/spring; term] Number of ECTS credits (or equivalent)8 to be awarded by the Receiving Institution upon successful completion Total: … Web link to the course catalogue at the Receiving Institution describing the learning outcomes: [web link to the relevant information] The of language competence9 in ________ [indicate here the main language of instruction] that the student already has or agrees to acquire by the start of the study period is: A1 A2 B1 B2 C1 C2 Native speaker Recognition at the Sending Institution