UNIVERSIDADE DOS AÇORES (PORTUGAL) GRI ― Gabinete de Relações Internacionais Edifício da Reitoria Rua da Mãe de Deus 9501-855 Ponta Delgada Tel.: +351 296 650 800 / Fax: +351 296 650 005 E-mail: [email protected] Lifelong Learning Programme ― ERASMUS ECTS - LEARNING AGREEMENT ACADEMIC YEAR 20___/ 20___ - FIELD OF STUDY: __________ Student’s name: ________________________________________________________________________________ Sending institution: ______________________________________________________________________________ Country: _______________________________________________________________________________________ DETAILS OF THE PROPOSED STUDY PROGRAMME ABROAD/LEARNING AGREEMENT Receiving institution: ____________________________________________________________________________ Country: _______________________________________________________________________________________ Course unit code Course unit title Number of ECTS credits (If necessary, continue the list on a separate sheet) Student’s signature: _____________________________________________________ Date: _____/_____/_____ Tel.: ____________________________ E-mail: _________________________________________________________ SENDING INSTITUTION We confirm that the proposed programme of study/learning agreement is approved. Departmental coordinator’s signature Institutional coordinator’s signature ___________________________________________ ___________________________________________ Date: _____/_____/_____ Date: _____/_____/_____ RECEIVING INSTITUTION We confirm that this proposed programme of study/learning agreement is approved. Departmental coordinator’s signature Institutional coordinator’s signature ___________________________________________ ___________________________________________ Date: _____/_____/_____ Date: _____/_____/_____