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Learning Agreement
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Student Mobility for Studies
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StudentLast Name (s)First Name (s)Date of birthNationalitySex (M/F)Study cycleField of education
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Sending InstitutionNameFaculty/DepartementAddressCountryContact person name; email;phone
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Receiving InstitutionNameFaculty/DepartementAddressCountryContact person name; email;phone
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Before the mobility
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Study Programme at the Receiving Institution
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Planned period of the mobility : from (month/year) September 2018 to (month/year) December 2018
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Table A Before the mobilityComponent code (if any)Component title at the Receiving Institution
(as indicated in the course catalogue)		Semester
(e.g. autumn/spring;term)		Number of credits (or equivalent) to be awarded by the Receiving Institution upon successful completion
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Total :
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Web link to the course catalogue at the Receiving Institution describing the learning outcomes : [web link to the relevant information]
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The level of language competence in: TOEFL 450 (indicate here the main language of instruction) that the student already has or agrees to acquire by the start of the study period is : A1 A2 B1 B2 C1 C2 Native Speaker
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Recognition at the Sending Institution
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Table B Before the mobilityComponent code (if any)Component title at the Sending Institution (as indicated in the course catalogue)Semester
 (e.g. autumn/spring;term)		Number of credits (or equivalent) to be recognised by the Sending Institution
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Total :
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Provision applying if the student does not complete successfully some educational components : http://ti.stiki.ac.id/download/
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Commitment
By signing this document, the student, the Sending Institution and the Receiving Institution confirm that they approve the Learning Agreement and that they will comply with all the arrangements agreed by all parties. Sending and Receiving Institution undertake to apply all the priciples agreed in the Inter-Institutional Agreement for Institutions located in Partner Countries. The Beneficiary Institution and the student should also commit to what is set out in the grant agreement. The Receiving Institution confirms that the educational components listed in Table A are in line with its course catalogue and should be available to the student. The sending Institution commits to recognise all the credits or equivalent units gained at the Receiving Institution for the successfully completed educational components and to count them towards the student's degree as described in Table B. Any exceptions to this rule are documented in annex of this Learning Agreement and agreed by all parties. The student and the Receiving Institution will communicate to the Sending Institution any problems or changes regarding the study programme, responsible person and/or study period.
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CommitmentNameEmailPositionDateSignature
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Student
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Responsible person at the Sending Institution
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Responsible person at the Receiving Institution(if any)
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