Call for the mobility of PhD students - 2017/2018: Application form (Attachment 2) Research and/or study programme Academic year 2017/2018 Sex Last Name (s) First Name (s) Date of Birth Nationality Study cycle [M/F] Student Erasmus Contact person Name Faculty/Department Address Country Code name; email; phone Sending Corso Giacomo I CASTELL 01 Institution Università - Matteotti, 22 (when Italy LIUC Castellanza applicable) (VA) 21053 Erasmus Contact person Name Faculty/Department Address Country Code name; email; phone Receiving Institution Mobility start date: ________________________ Mobility end date: ______________________________ Supervisor at the Sending University: _____________________________________ Supervisor at the : ____________________________________ [If required] The level of language competence in _________________ [indicate here the main language of instruction] that the student already has or agrees to acquire by the start of the mobility period is A1 A2 B1 B2 C1 C2 Native Speaker □ □ □ □ □ □ □ Research and/or study programme at the Receiving Institution Component code Research and/or study program and/or Component title at the Semester Number of ECTS [if any] Receiving Institution credits [or equivalent] Recognition at the Sending Institution Component code Research and/or study program and/or Component title at the Semester Number of ECTS [if any] Sending Institution credits [or equivalent] SENDING INSTITUTION RECEIVING INSTITUTION Università LIUC xxxxxxxxxxxxxxxxxxxxxx – Date: Date: Coordinator of the Ph.D. programme xxxxxxxxxxxxxxxxxxxxxx Raffaella Manzini xxxxxxxxxxxxxxxxxxxxxx ____________________ ____________________
Call for the mobility of PhD students - 2017/2018: Application form (Attachment 2) Research and/or study programme Academic year 2017/2018 Student Last Name (s) First Name (s) Date of Birth Nationality Sex [M/F] Study cycle Sending Institution Name Faculty/Department Erasmus Code Address Country Contact person name; email; phone Università - LIUC I CASTELL 01 (when applicable) Corso Giacomo Matteotti, 22 Castellanza (VA) 21053 Italy Receiving Institution Name Faculty/Department Erasmus Code Address Country Contact person name; email; phone Mobility start date: ________________________ Mobility end date: ______________________________ Supervisor at the Sending University: _____________________________________ Supervisor at the : ____________________________________ [If required] The level of language competence in _________________ [indicate here the main language of instruction] that the student already has or agrees to acquire by the start of the mobility period is □ A1 □ A2 □ B1 □ B2 □ C1 □ C2 □ Native Speaker Research and/or study programme at the Receiving Institution Component code [if any] Research and/or study program and/or Component title at the Receiving Institution Semester Number of ECTS credits [or equivalent] Recognition at the Sending Institution Component code [if any] Research and/or study program and/or Component title at the Sending Institution Semester Number of ECTS credits [or equivalent] SENDING INSTITUTION RECEIVING INSTITUTION Università – LIUC xxxxxxxxxxxxxxxxxxxxxx Date: Date: Coordinator of the Ph.D. programme xxxxxxxxxxxxxxxxxxxxxx Raffaella Manzini xxxxxxxxxxxxxxxxxxxxxx ____________________ ____________________
12_Allegato2_Agreement-Inglese.docx