Student Agreement study
Bijlage 1
Erasmusmobility
Lifelong Learning 2012-2013
STUDENT AGREEMENT STUDY MOBILITY
Between:
Name of home institution:
EUC number of home institution:
Erasmus Identity Code of home institution: NL
And:
Name of student:
(Student’s surname, followed by initials of the first name(s), so: Vries, P.R. de)
Date of birth: ……./……./19....
Gender: M / F1
Nationality:
Level of study: Bachelor / Master / Phd
Years of study completed before departure:
Subject area:
Address in the Netherlands:
Postal code and city:
Telephone number:
E-mail address:
Correspondence address or address of parents or guardians:
Postal code and city:
Telephone number:
Bank account number:
Name of host institution:
Erasmus Identity Code of host institution:
Country of host institution:
Duration of study abroad, in months (minimum of 3 months):
Period of study abroad: from ….. / …. / 20... until .... / ….. / 20…
Is a placement part of the study period? YES / NO If so, for how many months?
Is ECTS used as an instrument for credit transfer? YES / NO
Will the student follow courses conducted in the language of the host country? YES /NO
If NOT, in which language the courses are conducted?
Is an Erasmus grant given for an EILC language course? YES / NO
How many weeks takes the EILC language course (max 6 weeks): ………………….weeks
Total Erasmus grant acknowledged to the student (incl. EILC month): € ……….
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Student Agreement study
Bijlage 1
Erasmusmobility
Lifelong Learning 2012-2013
The parties above are in agreement with the following:
The student declares that within the framework of the Erasmusprogramme, he/she will spend the
period of time indicated above at the host institution indicated above, and that he/she agrees to the
conditions laid down in this contract and for which he/she (of the next conditions, the applicable one
should be marked):
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Will receive a mobility grant provided by the European Union under the terms of the Erasmus
University Charter of the student’s home institution.
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Will not receive a mobility grant but in all other respects will be considered a participant in
Erasmus (zero-grant student).
Mutual obligations:
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The institution is obliged to pay students their grants only after it has received the provisional
student mobility grants from Nuffic.
From the home institution the student receives the following forms:
1) Student Agreement. The agreement between the home institution and the student are settled
here. This form needs to be finalised and signed by the student and the home institution
before departure of the student.
2) Learning Agreement. This agreement between home institution, host institution and student
contains the courses the student will take and it needs to be filled in and signed before
departure of the student.
3) Statement of Host Institution. This form needs to contain the data of the home institution, the
name of the student as well as the data of the host institution. The host institution must write
the dates of the period of study, sign and place its official seal.
4) Student Report. At the end of the study period abroad the student must return this report in
electronic format to his home institution.
5) Erasmus Student Charter, which includes the rights and obligations of an Erasmus Student.
Before the student departs, the student and the home institution will agree on a plan for the
studies to be undertaken at the host institution and on the credit that the home institution will
award for the study abroad as though it were part of the study programme at home (learning
agreement). All such agreements will be confirmed in writing by the student, the home institution
and the host institution. Any revision to the Learning Agreement found to be necessary when the
student first arrives at the host institution shall be finalised and formalised within one month of the
student’s arrival. Any subsequent changes to the Learning Agreement shall be formally agreed by
the three parties.
At the end of the study period abroad, the host institution will give the student and his or her home
institution a certificate confirming the fact that the study plan was indeed carried out, and
presenting a list of the results (transcript of records).
Any proposed change in this agreement regarding the period of study will be submitted to the
home institution for its approval. If the home institution agrees to the change, it will confirm this in
writing to the student. This document will be appended to the present agreement.
Within 30 days after finishing the study abroad, which needs to be at least three months, the
student must submit the Statement of the Host Institution, the Transcript of Records and the
Student Report to the home institution, thus proving that the studies have taken place as
planned. If the student fails to deliver either of these documents, the home institution or Nuffic can
claim back a part of or the entire Erasmus grant from the student.
If possible before departure of the student, but within 45 days of the date of entry into force of this
agreement, the home institution will pay an advance of 70 % of the total grant, assuming the grant
from Nuffic is received.
If prior to the period of study abroad the student applies for an EILC course and is selected,
he/she is obliged to join this course. If unforeseen emergencies force the student to resign,
he/she should inform the institutions concerned as soon as possible.
In case the student fails to go abroad for any reason, he/ she is obliged to pay back the total
Erasmus grant. If the study period abroad was shorter than planned, the student must pay back
part of the money received. In case the student fails to live up to this agreement or the present
contract is dissolved, the student must pay back either all or part of the grant.
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Student Agreement study
Bijlage 1
Erasmusmobility
Lifelong Learning 2012-2013
The student declares that he/she meets the following requirements:
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Is registered in a programme, study or is pursuing an additional/postgraduate study at an
university or university of professional education, finishing with a recognised diploma from a
higher education institution.
Is a full-time student at the host institution.
Has completed the first year of study with success and has started the second year.
Has never before studied as an Erasmusstudent abroad (with an Erasmusgrant or as a zero-grant
student) as an Erasmus study period is allowed only once.
Will not apply for other scholarships or grants awarded through other EU programmes for the
study period to which this contract applies.
Will not use the Erasmus grant to cover costs that will be covered from another subsidized
source.
Failure to comply with the conditions and agreements laid down in this student contract can
be a reason for the home institution to dissolve the contract and claim back the total grant.
_________________________________________________________________________________
SIGNED AS AGREED
On behalf of the home institution,
The student,
Name:.................................
Name:................................
(Position)..............................:
Date:
…………………….
Date:
…………………….
Place: …………………….
Place: …………………….
Signature:
Signature:
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