Mobility Agreement Staff Mobility For Teaching Planned period of the teaching activity: 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 2016/2017 E-mail The Sending Institution/Enterprise UNIVERSITY of WARSAW Name Erasmus code PL WARSZAW01 Faculty/Department (if applicable) ul. Krakowskie Country/ Address POLAND / PL Przedmieście 26/28 Country code 00-927 Warszawa Contact person Sylwia Salamon sylwia.salamon Contact person name and position Erasmus+ Institutional @adm.uw.edu.pl e-mail / phone Coordinator <250 employees Size of enterprise Type of enterprise: not applicable >250 employees (if applicable) not applicable The Receiving Institution Name Faculty/Department Erasmus code (if applicable) Country/ Address 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 teaching activity: 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 2016/2017 E-mail The Sending Institution/Enterprise Name UNIVERSITY of WARSAW Erasmus code (if applicable) PL WARSZAW01 Faculty/Department Address ul. Krakowskie Przedmieście 26/28 00-927 Warszawa Country/ Country code POLAND / PL Contact person name and position Sylwia Salamon Erasmus+ Institutional Coordinator Contact person e-mail / phone sylwia.salamon @adm.uw.edu.pl Type of enterprise: not applicable Size of enterprise (if applicable) <250 employees >250 employees not applicable 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
STA_form.docx