Last name(s) First name(s) Date of birth Nationality Sex [M/F] Study cycle Field of education Student Erasmus code Name Faculty/Department (if applicable) Address Country Contact person name; email; phone Sending Institution Erasmus code Receiving Name Faculty/ Department (if applicable) Address Country Contact person name; email; phone Institution DURING the Mobility Exceptional changes to Table A (to be approved by e-mail or signature by the student, the responsible person in the Sending Institution and the responsible person in the Receiving Institution) Number of Table A2 Component Component title at the Receiving Deleted Added ECTS credits During the code Institution component component Reason for change (or mobility (if any) (as indicated in the course catalogue) [tick if applicable] [tick if applicable] equivalent) Exceptional changes to Table B (if applicable) (to be approved by e-mail or signature by the student and the responsible person in the Sending Institution) Table B2 Component Deleted Added Component title at the Sending Institution During the code component component (as indicated in the course catalogue) Number of ECTS credits (or equivalent) mobility (if any) [tick if applicable] [tick if applicable]
Student Last name(s) First name(s) Date of birth Nationality Sex [M/F] Study cycle Field of education Sending Institution Name Faculty/Department Erasmus code (if applicable) Address Country Contact person name; email; phone Receiving Institution Name Faculty/ Department Erasmus code (if applicable) Address Country Contact person name; email; phone DURING the Mobility Exceptional changes to Table A (to be approved by e-mail or signature by the student, the responsible person in the Sending Institution and the responsible person in the Receiving Institution) Table A2 During the mobility Component code (if any) Component title at the Receiving Institution (as indicated in the course catalogue) Deleted component [tick if applicable] Added component [tick if applicable] Reason for change Number of ECTS credits (or equivalent) Exceptional changes to Table B (if applicable) (to be approved by e-mail or signature by the student and the responsible person in the Sending Institution) Table B2 During the mobility Component code (if any) Component title at the Sending Institution (as indicated in the course catalogue) Deleted component [tick if applicable] Added component [tick if applicable] Number of ECTS credits (or equivalent)