Mobility Report: Teacher Mobility
Academic Year: _________________
Please indicate:
CEEPUS Network Number (CPnr.):___________________________
or
Freemover
Dear CEEPUS Scholarshipholder!
Your feedback is very important for CEEPUS, so please forward this report to your National
CEEPUS Office (NCO) within two weeks after returning from your host country or as
advised by your National CEEPUS Office! - Thank you!
Contact Addresses: National CEEPUS Offices
Austria:
Dr. Lydia Skarits
Büro für Austauschprogramme
mit Mittel- & Osteuropa
Alserstr. 4/1/15/6, A-1090 Vienna
Phone: (+43 1) 4277/28189
Fax: (+43 1) 4277/28195
E-mail: lydia.skarits@oead.ac.at
Bulgaria:
Dr. Rossiza Velinova
Ministry of Education and Science, Dept. for Int. Relations
2A Dondukov Bld., BG-1000 Sofia
Phone: (+359 2) 983 15 21
Fax: (+359 2) 988 06 00
E-mail: r.velinova@minedu.govrn.bg
Croatia:
Davor Šovagovič
Ministry of Science and Technology
Strossmayerov trg. 4, HR-41000 Zagreb
Phone: (+385 1) 4594 554
Fax: (+385 1) 48 19 331
E-mail: davor.sovagovic@mzt.hr
Czech Republic:
RNDr. Jitka Nováková
House for International Services
Senovážné nám. 26, PO BOX 8, CZ-110 06 Praha 1
Phone: (+420 2) 24 398 263
Fax: (+420 2) 24 22 25 83
E-mail: ceepus@dzs.cz
Hungary:
Adél Csernovitz
Hungarian CEEPUS Office
POB 510, H-1348 Budapest 70
Phone: +36/1/210 9700
Fax: +36/1/210 9701
E-mail: ceepus@tpf.hu
Poland:
Michael Skowronski
Bureau for Acad. Recognition and International Exchange
National CEEPUS Office Poland
Smolna Str. 13, PL-00920Warsaw
Phone: (+48 22) 828 2433, 826 7434
Fax: (+48 22) 826 2823
E-mail: ceepus@buwiwm.edu.pl
Romania:
Daciana Vijiitu
Ministry of National Education, National CEEPUS Office
Strada General Berthelot 30, RO-70738 Bucharest
Phone: +40/1/3157439
Fax: +40/1/3142680
E-mail:daciana@men.edu.ro
Slovakia:
Ingrid Vernerová
SAIA
Nám.Slobody 23, SK-81220 Bratislava 1
Phone: (+421 7) 5441 1426
Fax: (+421 7) 5441 1429
E-mail: ingrid@saia.sk
Slovenia:
Andrej Kotnik
Ministry of Education and Sports, Dept. for Int. Cooperation
Mailing address: Zupanciceva 6, SI-61000 Ljubljana
Phone: (+386 61) 1323225, 322776
Fax: (+386 61) 132 72 12
E-mail: andrej.kotnik@mss.edus.si
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1. Basic Personal Data:
1.1 Personal Data
academic degree:
first name:
last name:
sex:


male
female
date of birth:
citizenship:
1.2 Country of origin: please tick appropriate box:
= country of your home institution





Austria
Bulgaria
Croatia
Czech Rep.
Hungary




Poland
Romania
Slovakia
Slovenia




Poland
Romania
Slovakia
Slovenia
1.3 Host country : please tick appropriate box:
multiple entries if necessary





Austria
Bulgaria
Croatia
Czech Rep.
Hungary
1.4 Period of Stay
as in your Letter of Confirmation
from: (dd/mm/yy) ______to: (dd/mm/yy):______in: (host country):______________
from: (dd/mm/yy) ______to: (dd/mm/yy):______in: (host country):______________
from: (dd/mm/yy) ______to: (dd/mm/yy):______in: (host country):______________
1.4.1 Prolongation: Was your CEEPUS grant prolonged?
please tick appropriate box
 yes
 no
1.4.2 Duration: Total in scholarship months (incl. prolongation where applicable)
please tick appropriate box
1
2
3
4
5
6
7
2
8
9
10
11
12
1.5 Field of Study (Index copyright SAIA Slovenska)*
please mark the appropriate box according to your general field of study
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
o
140000
EDUCATION & TEACHER TRAINING
180000
FINE & APPLIED ARTS
220000
HUMANITIES
260000
RELIGION & THEOLOGY, GENERAL
300000
SOCIAL & BEHAVIOURAL SCIENCES
340000
BUSINESS ADMINISTRATION & MANAGEMENT
380000
LAW
420000
NATURAL SCIENCES
460000
MATHEMATICS & COMPUTER SCIENCE
500000
MEDICAL SCIENCES
520000
TECHNOLOGY
540000
ENGINEERING
580000
ARCHITECTURE & TOWN PLANNING
620000
AGRICULTURE, FORESTRY & FISHERY
660000
HOME ECONOMICS (DOMESTIC SCIENCE)
700000
TRANSPORT & COMMUNICATIONS
780000
SERVICE TRADES
840000
MASS COMMUNICATION & INFORM. SCIENCES
890000
SECURITY & RECREATION
1.6 Local Denomination of your Field of Study (in English)
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2. Teaching Abroad
2.1 Host Institution:
university:
faculty/institute:
country:
where applicable also second host institution:
university:
faculty/institute:
country:
2.2 Activities: Please give a short description of your teaching activities at your
host institution:
2.3 Organizational details: please tick appropriate box
2.3.1: Preparation:
Did you encounter any difficulties while preparing for your period of teaching abroad?
 no
 yes
if yes, please specify: (keywords)
2.3.2 Payment of Scholarship: Agency
By which agency/institution was your scholarship paid?
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2.3.3 Payment of Scholarship: Intervals
At which intervals was your scholarship paid?
 monthly
 weekly
 other interval:__________
2.3.4 Optional Funding:
Did you receive any additional CEEPUS funding/fringe benefits by authorities or
institutions in your home country and/or your host country?
 yes
 no
if yes, please specify:
 travel allowance
 others, please specifiy:
2.5.5 Accommodation: Preparation
Upon arrival at your host institution, how did you arrange for accommodation?
multiple entries possible
 accommodation was arranged by host institution
 checked local market with assistance of:_______________
 checked local market alone
 other arrangement:________________________________
2.5.6 Accommodation: Type
Which type of accommodation did you use: multiple entries possible
 student hostel
 private room
 guest house
 other type of accommodation: _______________
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 hotel
 private flat
3. Possible improvements
If you have suggestions for improvement, please let us know:
I agree to electronic processing of the data provided
Signature: _______________________________
Date:____________________
THANK YOU FOR YOUR COOPERATION!!!
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