Erasmus Teaching Mobility
WORK PLAN /
Please fill in this plan electronically before printing
Personal Data
Mr Ms / Family Name: / Forename(s):
Nationality: / Turkish ID Number (or passport number for foreign staff):
Date of Birth: / Field of Responsibility:
International Affairs Teaching Student Information
Technical or General Administration Finance
Staff with disabilities
(Yes/No) / If yes, we invite you to disclose this information so that your needs can be addressed and you can apply for an additional grant in order to cover the extra costs which may incur during your Erasmus+ mobility
Seniority:
Junior Intermediate Senior
E-mail Address:
Phone Number(s):
Fax Number (if there is any):
Home Institution
Name of the Home Institution / Istanbul Kemerburgaz University
Erasmus ID Code / TR ISTANBU38
Department
Institutional Erasmus Coordinator / Senay Gumus
Contact Details of the Institutional Erasmus Coordinator / E-mail Address:
Phone Number: 00 90 (212) 604 01 00
Host Institution/Enterprise/Organization
Name of the Host Institution/Enterprise/Organization
Country
Erasmus ID Code (when the host is a higher education institution)
Faculty and/or Department
Information Relating to the Host Enterprise/Organization (only when the host is an enterprise or an organization) / Micro/Small < 50 staff
Medium : 50-250 staff
Large : 250 or more staff
Name of the Contact Person
Position of the Contact Person
Contact Details of the Contact Person / E-mail Address:
Phone Number:
Content of the Training Activities
Form of the Staff Training / Workshop/Seminar Training
Work Shadowing
Period of the Mobility (arrival and departure dates)
Communication Language for the Training
Overall Aim and Objectives of the Mobility:
Expected Results:
Daily Program of the Training Activities
You can add as many lines as needed by pressing the ENTER key in each column
Date / Subject / Hours
This work plan must be approved by both the sending and the host institution.
Staff’s Signature:______Date:Home Institution : We confirm that the above proposed work plan is approved.
Head of the Department
Name:
Signature:
Date: / Institutional Erasmus Coordinator
Name: Senay Gumus
Signature and Stamp:
Date:
Host Institution: We confirm that the above proposed work plan is approved.
Institutional (Erasmus) Coordinator
Name:
Signature and Stamp:
Date: