Trainee	Last name(s)	First name(s)	Date of birth	Nationality	Sex [M/F]	Study cycle	Field of education	

Sending Institution	Name	Faculty/ Department	Erasmus code(if applicable)	Address	Country	Contact person name; email; phone	

ReceivingOrganisation/Enterprise	Name	Department	Address; website	Country	Size	Contact person name; position; e-mail; phone	Mentorname; position;
e-mail; phone	
					☐< 250 employees
☐> 250 employees			

During the Mobility

	Table A2 - Exceptional Changes to the Traineeship Programme at the Receiving Organisation/Enterprise
(to be approved by e-mail or signature by the student, the responsible person in the Sending Institution and the responsible person in the Receiving Organisation/Enterprise)	

Planned period of the mobility: from [month/year] ……………. till [month/year] …………….	
Traineeship title: …
	Number of working hours per week: …	
Detailed programme of the traineeship period:

Knowledge, skills and competences to be acquired by the end of the traineeship (expected Learning Outcomes):
	
Monitoring plan:

Evaluation plan: