Mobility Agreement Staff Mobility For Teaching Planned period of the teachingactivity: from [day/month/year] till [day/month/year] Duration (days) excluding travel days: – …………………. The teaching staff member Last name (s) First name (s) Seniority Nationality Sex[M/F] Academic year 20../20.. E-mail The Sending Institution/Enterprise Name UNIVERSITY OF LODZ Erasmus code PL LODZ01 Faculty / Faculty of (if applicable) Department Economics and Sociology Address Ul. Rewolucji 1905 r. Country/ Poland/PL 41/43 90-255 Country code Łódź Contact person Faculty Exchange Contact person +48 889 162 263 name Programmes Coordinator e-mail and position Tomasz Schabek / phone Ph.D. +48 42 635 48 14 Type of Size of <250 employees enterprise: enterprise >250 employees (if applicable) The Receiving Institution Name Faculty/Department Erasmus code (if applicable) Address Country/ Country code Contact person Contact person name and position e-mail / phone For guidelines, please look at the end notes on page 3 Section to be completed BEFORE THE MOBILITY
Mobility Agreement Staff Mobility For Teaching Planned period of the teachingactivity: from [day/month/year] till [day/month/year] Duration (days) – excluding travel days: …………………. The teaching staff member Last name (s) First name (s) Seniority Nationality Sex[M/F] Academic year 20../20.. E-mail The Sending Institution/Enterprise Name UNIVERSITY OF LODZ Erasmus code (if applicable) PL LODZ01 Faculty / Department Faculty of Economics and Sociology Address Ul. Rewolucji 1905 r. 41/43 90-255 Łódź Country/ Country code Poland/PL Contact person name and position Faculty Exchange Programmes Coordinator Tomasz Schabek Ph.D. Contact person e-mail / phone +48 889 162 263 +48 42 635 48 14 Type of enterprise: Size of enterprise (if applicable) <250 employees >250 employees The Receiving Institution Name Faculty/Department Erasmus code (if applicable) Address Country/ Country code Contact person name and position Contact person e-mail / phone For guidelines, please look at the end notes on page 3 Section to be completed BEFORE THE MOBILITY
staff-mobility-agreement-teaching_integr_2016-pre-filled-ts-2017.docx