ERASMUS MOBILITY PROGRAMME 2017-2018

BIDS FOR MOBILITY BY ACADEMIC AND SUPPORT STAFF

Details of staff member who will undertake the visit:

* Please note that this information is requested by the British Council and is required for reporting purposes and statistical data only

Name

Sex*

Nationality*

Age*

Job Title

Faculty/Department

Seniority level * Junior / Intermediate / Senior (circle or delete as appropriate)

JUNIOR=L/SL /INTERMEDIATE=Associate Prof./SENIOR=Prof./OTHER Name of Faculty / Department

Type of visit Teaching / Training (delete as appropriate)

Teaching Name of host university:

Host department:

Level of teaching (UG/PG):

Subject area:

Key Contact:

Email:

Training Name of host university:

Type of training activity: (e.g. workshop / training / shadowing / secondment, other)

Type of host enterprise:

Key Contact:

Email:

Proposed duration of activity in days (do not include holiday time)

Approximate dates of visit From: To:

Aims and objectives of visit

What do you anticipate will be the benefits for your placement? (Please include benefits on yourself, your department and the University)

Anticipated costs:Please refer to guidelines for costing

Travel:

Subsistence:

Accommodation:

Signature of Applicant:

Date:

Recommendation / Supporting statement by Head of Department/Dean:

In order to help us to prioritise applications, please provide a supporting statement, making particular reference to:

How the opportunity will develop the individual/make an impact in the individual's job role.

How the opportunity links to the individual’s career development

How the individual and the manager will know what impact the learning has had on their work and their job

How this development opportunity will contribute to the strategic objectives of the department

HOD/Deans Signature:

Date:

This form needs to be returned to Shauna Anton, Staff Development Co-ordinator, Personnel Office or via email on eras.

Erasmus Funding Approved By: