Annex 2-LEARNING AGREEMENT for STUDIES 2016-2017

Annex 2-LEARNING AGREEMENT FOR STUDIES 2016-2017

Return a digital (scanned) copy of the completed and signed sections BEFORE the mobility (no. 1and 2) at least 2 weeks before the start of your Erasmus+ study period via email to: .
If you are unable to send the Learning Agreement within the indicated timeframe mentioned above,
you must fill out a request form to push the deadline forward and send it to least 2 weeks before the start of your Erasmus+ study period.
Questions? Please contact your International Exchange Coordinator.

Section to be completed BEFOREthe mobility –no. 1

Personal details of the student(to be completed by the student)

Last name(s) / First name(s)
Date of birth / Nationality[1]
Sex [M/F] / Academic year / 2016/2017
Study cycle[2]
[Bachelor/Master/Phd] / Subject area,
Code[3]
Phone number / Email address

The Sending Institution(to be completed by the International Exchange Coordinator)

Name / Leiden University / Faculty
Erasmus code
(if applicable) / NL LEIDEN 01 / Department
Address / Country,
Country code[4] / The Netherlands, NL
Name
contact person / Email address &
phone number
contact person

The Receiving Institution(to be completed by the receiving/host institution)[5]

Name / Faculty
Erasmus code
(if applicable) / Department
Address / Country,
Country code4

The Receiving Institution(continued from previous page)

Name
contact person / Email address &
phone number
contact person

Section to be completed BEFORE the mobility – no. 2

I. PROPOSED STUDY PROGRAMME ABROAD

Planned period of the mobility[6] / From ../....[month/year] / To ../ ....
[month/year]
Table A: Study programme abroad (to be completed by the student)
Componentcode[7]
(if any) / Component title at the receiving institution (as indicated in the course catalogue) / Semester [autumn / spring]
[or term] / Number of ECTS credits to be awarded by the receiving institution upon successful completion
Total:

Web link(s) to the course catalogue at the receiving institution describing the learning outcomes:(to be completed by the student)

Web link(s) /
Table B: Study programme at Leiden University that will be replaced by the study programme abroad(to be completed by the student)
Please list the educational components in your degree that would normally be completed at the sending institution and which will be replaced by the study abroad. No one-to-one match with Table A is required. In those cases where all credits in Table A are recognised as forming part of the programme at the sending institution without any further conditions being applied, Table B may be completed with the simple reference ‘mobility window’ (at Leiden University this is also referred to as minor, free elective space or optional components).
Component code
(if any) / Component title at the sending institution (as indicated in the course catalogue) / Semester [autumn / spring]
[or term] / Number of ECTS credits
Total:

If the student does not successfully complete one or more educational components, the following provisions will apply:

Language competence of the student(to be completed by the Int. Exchange Coordinator)
The level of language competence[8] in [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 

II.RESPONSIBLE PERSONS

Responsible personin the sending institution:
(to be completed by the Board of Examiners / in Dutch: examencommissie)
Name: / Position:
Phone number: / Email:
Responsible personin the receiving institution:
(to be completed by the receiving institution)
Name: / Position:
Phone number: / Email:

III. COMMITMENT OF THE THREE PARTIES
By signing this document, the student, the sending institution and the receiving institution confirm that theyapprove theLearning Agreement and that they will comply with all the arrangements agreed by all parties.The sending and receiving institutions undertake to apply all the principles of the Erasmus Charter for Higher Education relating to mobility for studies.The sendinginstitution and the student also commit to what is set out in the Erasmus+ 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 commitsto recognise all the credits 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 an annex of this Learning Agreement and agreed by all parties.

The student and receiving institution will communicate to the sending institution any problems or changes regarding the study programme, responsible persons and/orstudy period.

The student(to be signed by the student)
Student’s signature: / Date:
The sending institution(to be signed by the Board of Examiners)
Responsible person’s
signature: / Date:
The receiving institution(to be signed by the receiving institution)
Responsible person’s
signature: / Date:

! Please note: the student is responsible for obtaining all signatures !
Section to be completed DURING the mobility

CHANGES TO THE ORIGINAL LEARNING AGREEMENT

The Scholarships Team needs to be informed if any of the following changes to the original Learning Agreement occur duringyour Erasmus+ study period abroad:

a change in the proposed study programme – deadline: within 7 weeks after the start of your Erasmus+ study period
a change in the end date of the study period – deadline: at least one month before the end date on the grant agreement

Return a digital (scanned) copy of the completed and signed Changes to the Original Learning Agreement by email to: .
Questions? Please contact your International Exchange Coordinator.

Personal details of the student(to be completed by the student)

Last name:
First name:
Student number:

I.EXCEPTIONAL CHANGES TO THE PROPOSED STUDY PROGRAMME

Table C: Exceptional changes to study programme,
including additional components in case of extension of study period abroad
(to be completed by the student)
Component code (if any) at the receiving institution / Component title (as indicated in the course catalogue) at the receiving institution / Deleted component
[tick if applicable] / Added component
[tick if applicable] / Reason for change[9] / Number of ECTS credits to be awarded by the receiving institution upon successful completion of the component
□ / □
□ / □
Total: …………

II.CHANGES TO THE STUDY PERIOD ABROAD(to be completed by the student)

Original start date:

.. / .. / ....

[day / month / year]

New end date:

.. / .. / ....

[day / month / year]

COMMITMENT OF THE THREE PARTIES

The student, the sending institution and the receiving institution hereby confirm their approval of the above-mentioned changes to the study programme abroad.

The student (to be signed by the student)
Student’s signature: / Date:
The sending institution (to be signed by the Board of Examiners)
Name: / Position:
Responsible person’s
signature: / Date:
The receiving institution (to be signed by the receiving institution)
Name: / Position:
Responsible person’s
signature: / Date:

! Please note: the student is responsible for obtaining all signatures !
Section to be completed AFTERthe mobility –no. 1
Statement of the Host Institution

Please return a digital (scanned) copy of the completed and signed Statement of the Host Institution[10]within 5 weeks after the end date of your Erasmus+study period via email to: .

Personal details student(to be completed by the student)

First name:
Last name:
Date of birth:

Details sending institution

Name
sending institution: / Leiden University
EUC number
sendinginstitution: / 28798
Erasmus Identity Code sending institution: / NL LEIDEN01

The undersigned hereby declares that the above-mentioned student has completed his/her study period at: (to be completed and signed by the host institution)

Name host institution: / Duration of study:
[in months]
Erasmus Identity Code host institution: / Start and end date of study:
[dd/mm/year] / from .. / .. / ....
up to and including
.. /.. / ....
SIGNATURE
Signed on behalf of the host institution by:
Name:
Date:
Signature: / Host institution’s
seal:

Section to be completed AFTERthe mobility–no. 2

Transcript of Records

After the completion of your study period abroad, you need to hand in the Transcript of Records provided by your receiving institution. Please send a digital (scanned) copyof thisTranscript of Records within 5 weeks after the end date of your Erasmus+ periodvia email to: .

RECEIVING INSTITUTION’S TRANSCRIPT OF RECORDS

The Transcript of Records at the Receiving Institution should contain at least the information mentioned in table E below.

Table E: Transcript of Records at the Receiving Institution
Component code
(if any) / Component title at the receiving institution (as indicated in the course catalogue) / Was the component successfully completed by the student? [Yes/No] / Number of ECTS credits (or equivalent) / Grades received at the Receiving Institution

II. SENDING INSTITUTION'S TRANSCRIPT OF RECORDS

In some cases, you may also be required to provide a Transcript of Records from Leiden University.You will be informed by the Scholarships Department if this condition applies to your Erasmus+ grant. The Transcript of Records of Leiden University can be found in uSis.

The Transcript of Records of the Sending Institution should contain at least the information mentioned in table F below.

Table F: Transcript of Records and Recognition at the Sending Institution
Component code
(if any) / Title of recognised component at the Sending Institution(as indicated in the course catalogue) / Number of ECTS credits recognised (or equivalent) / Grades registered at the Sending Institution grade, (if applicable)

[1] Nationality: Country to which the student belongs administratively and that issues the ID card and/or passport.

[2] Study cycle: Short cycle, EQF level 5 / bachelor or equivalent first cycle (EQF level 6) / master or equivalent second cycle (EQF level 7) / doctorate or equivalent third cycle (EQF level 8).

[3] You can use the ISCED-F 2013 search tool available at to find the ISCED-F 2013 detailed field of education and training that is closest to the subject of the degree that you will be awarded by Leiden University.

[4] Please add the relevant ISO 3166-2 country code, available at:

[5] Within the Erasmus+ programme the terms ‘receiving institution’ and ‘host institution’ are used interchangeably.

[6]Please note that the start and end date that you filled out on the online application form are used to calculate the level of your Erasmus+ grant (as stated in the Grant Agreement).

[7]An "educational component" is a self-contained and formal structured learning experience that features learning outcomes, credits and forms of assessment. Examples of educational components are: a course, module, seminar, laboratory work, practical work, preparation/research for a thesis, mobility window or free electives.

[8]See for more information:

[9]Please choose an item number from the table below:

Reasons for deleting a component: / Reasons for adding a component:
1. Previously selected educational component is not available at the receiving institution / 5. Substituting a deleted component
2. Component is in a different language than previously specified in the course catalogue / 6. Extending the mobility period
3. Timetable conflict / 7. Other (please specify)
4. Other (please specify)

[10]Within the Erasmus+ programme the terms ‘receiving institution’ and ‘host institution’ are used interchangeably.