Last name(s) name(s) Date of birth Nationality Sex [M/F] Study cycle Field of education Student First: Second: Sending Name of Institution Faculty/Department Erasmus code Address, City, Country Institution Heinrich-Heine-University D DUSSELD01 Universitaetsstr. 1, 40225 Duesseldorf, Germany Contact Last name(s) name(s) person Receiving Name of Institution Faculty/Department Erasmus code Address, City, Country Institution Contact Last name(s) name(s) Email Phone person Before the mobility Planned period of the mobility: from [month/year] to [month/year] …………………….……. …………………….……. please choose components amounting to at least 20 ECTS credits Programme at the Receiving Institution for first field of education A Semester [e.g. Number of ECTS credits (or equivalent) Component Component at the Receiving Institution Before the No. autumn/spring; to be awarded by the Receiving code (if any) (as indicated in the course catalogue) mobility term] Institution upon successful completion 1 2 3 4 5 6 Total: Web link to the course catalogue at the Receiving Institution describing the learning outcomes: Study Programme at the Receiving Institution for second field of education Table AA Semester [e.g. Number of ECTS credits (or equivalent) Component Component title at the Receiving Institution Before the No. autumn/spring; to be awarded by the Receiving code (if any) (as indicated in the course catalogue) mobility term] Institution upon successful completion 1 2 3 4 5 6 Web link to the course catalogue at the Receiving Institution describing the learning outcomes: The level of language competence in _______________________ [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 for first field of education Please consult your faculty for the recognition and any related questions. Semester [e.g. Number of ECTS credits (or equivalent) Table B Corresponding Component at the Sending Institution (as indicated in the autumn/spring; to be recognised by the Sending no. in Table A course catalogue/curriculum of the sending institution) Before the term] Institution mobility Total: Provisions applying if the student does not complete successfully some educational components:
Student Last name(s) name(s) Date of birth Nationality Sex [M/F] Study cycle Field of education First: Second: Sending Institution Name of Institution Faculty/Department Erasmus code Address, City, Country Heinrich-Heine-University D DUSSELD01 Universitaetsstr. 1, 40225 Duesseldorf, Germany Contact person Last name(s) name(s) Receiving Institution Name of Institution Faculty/Department Erasmus code Address, City, Country Contact person Last name(s) name(s) Email Phone Before the mobility Planned period of the mobility: from [month/year] …………………….……. to [month/year] …………………….……. please choose components amounting to at least 20 ECTS credits Programme at the Receiving Institution for first field of education A Before the mobility No. Component code (if any) Component 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 1 2 3 4 5 6 Total: Web link to the course catalogue at the Receiving Institution describing the learning outcomes: Study Programme at the Receiving Institution for second field of education Table AA Before the mobility No. 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 1 2 3 4 5 6 Web link to the course catalogue at the Receiving Institution describing the learning outcomes: The level of language competence in _______________________ [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 for first field of education Please consult your faculty for the recognition and any related questions. Table B Before the mobility Corresponding no. in Table A Component at the Sending Institution (as indicated in the course catalogue/curriculum of the sending institution) Semester [e.g. autumn/spring; term] Number of ECTS credits (or equivalent) to be recognised by the Sending Institution Total: Provisions applying if the student does not complete successfully some educational components:
SMS_E__LA_Learning_Agreement_for_Studies_16-17_zwei_Faecher.docx