Name: _________________________________ (Person in charge of international student mobility) at _________________________________________________ (host university) ERASMUS code: ______________ Country: ______________ HEREBY CERTIFIES: That Mr./Ms. _________________________________________ (outgoing student, University of Barcelona) either participating in the 20../20... Erasmus programme or studying here under a bilateral agreement has applied to extend his/her period of study at __________________________________________________ (host centre: Faculty, Department, Institute, etc.) from __________________ to __________________ (start date: dd/mm/yy) (end date: dd/mm/yy) And that the application has been accepted by this institution. Signature: Stamp: ______________ (name and title) _________________ (place and date)