Erasmus+ ICM Before Mobility Form for Incoming Student Participants

DATA DECLARATION FOR PREPARING THE GRANT AGREEMENT

Given name (as in passport)

Family name (as in passport)

Place of birth (town, country)

Date of birth (DD/MM/YYYY)

Nationality (as in passport)

Home address (permanent) - Please provide the following data: zip code, country, town, street name, street number.

Phone number (with country code)

E-mail address (one that you use)

Sex

Passport number

Academic year (when the mobility takes place)

Number of completed semesters in higher education (when starting the mobility)

Study cycle (during the mobility)

Your field of studies (such as law, history, geoinformatics etc.)

Field of studies with 4 digit ISCED code

You may find the ISCED code here.

FINANCIAL DETAILS

You will participate in a mobility with

financial support from Erasmus+ EU funds

zero grant (free waiver, without Erasmus+ support)

Bank account where the financial support should be paid

Bank account holder's name

Bank name

Clearing/BIC/SWIFT code (Bank identification code)

Account number with IBAN-code

Currency of the Bank Account*

*When choosing from the above options, please take into account that ELTE will pay your grant support in euros. In order to avoid paying unnecessary fees, you may wish to consider opening a euro bank account or find any other favorable option for receiving your grant support.

If you have chosen "Other", please specify

DATES OF THE MOBILITY PERIOD

Start date of the mobility

The start date of the mobility period shall be the first day that the participant needs to be present at the receiving organisation. In case travel has to be brought forward due to a mandatory quarantine (or other official measure with the same effect) that precedes this day, the start date of the mobility period shall be the first day of quarantine.

End date of the mobility

The end date of the period abroad shall be the last day the participant needs to be present at the receiving organisation.

For finding out the correct start and end dates of your mobility, please see ELTE's academic calendar here or inquire at your ELTE faculty coordinator.

HEALTH INSURANCE

If you are an incoming student, please bear in mind that your health insurance should be one that is accepted in the EU (covers at least 30 000 EUR possible expenes and valid within the Schengen Area) and covers the entire mobility period.

Name of the health insurance company

Policy number of your health insurance (unique number identifying your health insurance account)

MANDATORY ATTACHEMENTS

Learning Agreement (signed by all parties)

No file selected

Scanned copy of passport

No file selected

Scanned copy of health insurance policy or insurance card

No file selected

Certificate of Student Status*

No file selected

*The certificate should confirm that you are a student of your home university and will be enrolled there during the entire mobility period. This document shall certify that you are an active, registered student at your home university during the entire mobility period. The certificate can be accepted only if it contains the signature of the issuing person and the stamp of the sending institution.

DECLARATION OF PROMOTIONAL ACTIVITY

The aim of the promotional activity is to promote the Erasmus+ ICM program by sharing your experiences gained during the mobility period on ELTE’s website. Students undertaking promotional activities can choose the form of them. The submitted promotional materials may be published. In case of an in-person presentation, students may be asked to present their experiences at Erasmus+ ICM events, information days etc. Promotional activities are not obligatory.

If you would like to share your scholarship experiences and thus contribute to the promotion of the Erasmus+ ICM program at ELTE, please indicate the preferred form of it (you can indicate more):

Presentation at Erasmus+ ICM promotion events, information days etc.

Photo report (at least 10 photos of the mobility period with a personal introduction and description of 2-3 sentences per picture)