The Student Last name(s) First name(s) Date of birth Nationality Gender [M/F] Study cycle Field of Education Phone E-mail The Sending Institution Name Brunel University London College Erasmus code UK UXBRIDG01 Department Academic Partnerships (if applicable) Address Kingston Lane, Uxbridge Country United Kingdom Middlesex, UB8 3PH Contact person Angela Koh Contact person +44(0)1895 +44 (0)1895 267121 name e-mail / phone The Receiving Institution Name Faculty/College Erasmus code Department (if applicable) Address Country Contact person Contact person name e-mail / phone BEFORE the Mobility Study Programme at the Receiving Institution Planned period of the [day/month/year] mobility: from [day/month/year] ……………. to …………… Table A Number of ECTS credits (or Component Semester Component title at the Receiving Institution equivalent) to be awarded by Before code [e.g. autumn/spring; (as indicated in the course catalogue) the Receiving Institution upon the (if any) term] successful completion) mobility
The Student Last name(s) First name(s) Date of birth Nationality Gender [M/F] Study cycle Field of Education Phone E-mail The Sending Institution Name Brunel University London College Erasmus code (if applicable) UK UXBRIDG01 Department Academic Partnerships Address Kingston Lane, Uxbridge Middlesex, UB8 3PH Country United Kingdom Contact person name Angela Koh Contact person e-mail / phone +44(0)1895 +44 (0)1895 267121 The Receiving Institution Name Faculty/College Erasmus code (if applicable) Department Address Country Contact person name Contact person e-mail / phone BEFORE the Mobility Study Programme at the Receiving Institution Planned period of the mobility: from [day/month/year] ……………. to [day/month/year] …………… Table A Before the mobility Component code (if any) Component title at the Receiving Institution (as indicated in the course catalogue) Semester [e.g. autumn/spring; term] Number of ECTS credits (or equivalent) to be awarded by the Receiving Institution upon successful completion)