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Name of student: Sending institution: Country: Details of the proposed study programme abroad Receiving institution: Country: Course Code if any Course title SemesterReceiving institution credits ECTS credits ------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------------------------------------------------------------- Students signature:....................................... Date:.................................... Sending institution: We confirm that the proposed programme of study/learning agreement is approved Departmental coordinators signature Institutional coordinators signature ------------------------------------------ -------------------------------------------- Date:----------------------------------- Date: ------------------------------------- Receiving institution: We confirm that the above-listed changes to the initially agreed programme of study/learning agreement are approved Departmental coordinators signature Institutional coordinators signature ------------------------------------------ -------------------------------------------- Date:----------------------------------- Date: ------------------------------------- Changes to original proposed study programme/learning agreement (to be filled in only if appropriate) Name of student:Sending institution: Country: Course code if anyCourse title (as indicated in the information package) SemesterDeleted Added course course unit unitECTS Credits ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O  ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Students signature:....................................... Date:.................................... 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