Form | Learn | Truni international

Mobility scheme: Learn

Form Type: B1

Enter your personal information

Name *

Surname *

Gender *

Titles before name

Titles after name

Date of birth *

Permanent residence *

Uveďte adresu v tvare: ulica číslo, PSČ mesto, krajina.

Temporary residence

Uveďte adresu v tvare: ulica číslo, PSČ mesto, krajina.

Private email *

Phone *

Enter your study information

Faculty name *

Name of your department *

Name of the host institution or university *

Country of the host institution or university *

Email of the contact person at the host institution you are in contact with *

Enter your mobility information

Expected start date of mobility (from arrival at destination) *

Expected end date of mobility *

Brief description of objectives and expected results of the planned Erasmus+ mobility *

Mobility type *

Mobility subtype *

Provide the IBAN of the bank account where the grant will be transferred *

Provide the full name of the bank account holder where the grant will be transferred *

Bank where the bank account receiving the grant is held *

I agree to the processing of personal data for purposes related to the organisation of Erasmus+ mobility

I confirm that all information provided in the application is true

Learn - Form