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1-KEMENTERIAN RISET, TEKNOLOGI, DAN PENDIDIKAN TINGGI

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INSTITUT PERTANIAN BOGOR

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Telepon (0251) 8622642, Facsimile (0251) 8622708, http://www.ipb.ac.id

Nomor

Lampi ran

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Yth.

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7 :

I

(satu)

berkas

: Tawaran Erasmus

+

di

Univ

e

rsitas

Zagreb,

Krou

sia

I

.

Para Ketua

Departemen

2 .

Wakil Dekan

Seko

l

ah

Pascasa1jana

I

n

stitut

Pertan ian

Sogor

f?-

Nove

mb

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2017

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AGENDA

DEPT. AGH

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Sebaga

i

bentuk ke1:ja

sa

ma

an

tar

a

IP

S

dan

Un

i

versitas Zagreb,

Kroa

s

ia

,

denga

n h

onnat

kami

sampa

ik

a

n

inf

o

nna

si

mengenai tawaran

untu

k

mengikuti program

Erasmus+ Exchange for Staff and

Students

di

Un

i

vers

it

as Zagreb,

Kroa

s

ia.

Un

tuk

pelaksanaan

mobilitas

ta

hun

20

1 8,

IP

B dapat

mengirimkan

tiga

mahasiswa

dan

ti

ga

staf

pengajar ke

U

ni

ve

rs

it

as Zagreb.

Sagi

ya

n

g

berminat

,

form

11lir

pendaftaran

dan

infonnasi

se

len

gkap

n

ya dapat

dilihat pada berka

s

terlampi1·

ata

u

dengan

mengunjungi alamat

website:

• http:

//

www.

~•nizg.

h

r

/

homepa

ge/

in

ternational-rela tions

/

partn

e

t

·shi

ps

/

erasm

us

/

erasmus-ka

10

7 -pat·tner-countdeslin

fo-incom ing-

st

ud

en

ts-ka

10

7 I

• http

:llwww

.u n

izg.

h r

l

homepag

eli

nt

er

na

tiona

1- rei

a

tions

/

pa

rtnersh i

p

sleras

m u

sle

rasm u

s-kal 07 -pat'tner-coun tries/in

fo-in

com

in

g-staff

-k

a

I 07

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hubun

ga

n

dengan

h

a

l

di

a

t

as

.

kami

m

o

h

o

n

bantuan Sauclara kiran

ya

informasi

ini

dapat

cliseba

l"lu

askan kepacla

s

tafclan

maha

s

i

swa ya

n

g

be

r

minat eli

lingkung

a

n

Sauclara. Untuk

inf

o

ma

si

l

ebih

l

anj

u

t

dapat m

eng

h

ubungi Dr.

Yeni Hercli

yen

i

(Koordi

n

ator Erasm

us+

I

PS

-

Un

i

vers

it

as

Zagreb)

eli

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llmu

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1 i1pute

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Fakultas

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i

ka

dan

I

PA.

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lam

ara

n ya

ng

suda

h

l

e

n

gkap dapat dik

irim

ke D

ir

ektorat

Kerja

sa

m

a

dan Pro

g

ram lnternasional

,

Gd

.

A

ndi

Hakim

Na

s

oetion

Lt.

I

IPS

sebelum

tan

gga

l

24 Nove

mber

20

1

7 .

Demikia

n

kam

i sa

mpaikan

,

alas perhatian dan ke

1 :ja

s

ama

ya

ng baik

cli

ucapka

n

terima ka

s

ih.

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m

b

u

sa

n

:

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bidang

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o

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dang

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a,-a Dekan Fakulta

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tur Ke1:jasama dan

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(2)

'-GfNA-11-C-Annex IV-Erasmus+ HE Staff Mobility Agreement for teaching

Higher Education

ErasmUS

+

Mobi_H~v

Agreement torm Part1c1pant's name

STAFF MOBILITY FOR TEACHING

1 MOBILITY AGREEMENT

Planned period of the teaching

activity: from

[day/month/year]

till

[day/

month/ye

ar]

Duration (days)

-excluding

travel days: .

....

...

..

.

....

.

...

.

..

The teaching staff member

Last name (s)

First

name

(s)

Seniority

2

_Nationality

3

Sex [M/

F]

Academic

year

20 .

.

/20

..

·· - · - ·

E-mail

The Sending Institution/Enterprise

4

Name

Erasmus

code

5

_{not applicable}

_Faculty

_/Department

(if applicable)

Address

Country/

Country code

6

Contact person

Contact

person

name

and

position

e-mail

i

phone

Type of

enterprise:

Si

ze

of

enterprise

0 < 250 employees

NACE

code

7 (if applicable) ₀

> 250 employees

(if applicable)

The Receiving Institution

Name

Faculty/Department

Erasmus code

HRZAGREB01

(if applicable)

Address

Country

/

HR

Country

code

Contact person

Zeljka

Pitner,

IRO

Contact

per

s

on

zelj ka.

Qitner(Qlu ni

zg.

h

r;

name

and

positio

e-mail

i

phone

00385

1 46 98

105

--- ---- · · --

(3)

GfNA-11-C-Annex IV-Erasmus+ HE Staff Mobility Agreement for teaching

Higher Education

Erasm

us

+

Mobi_li~v

Agreement

torm

Part1c1pant's name

Section to be completed BEFORE THE MOBILITY

I. PROPOSED MOBILITY PROGRAMME

Main subject field

8_{: .}_.._.._.._._._._.._._.._..._.._{. .}

Level (select the main one): Short cycle (EQF level 5)

0 ; Bachelor or equivalent first

cycle (EQF level 6)

0 ; Master or equi

v

alent second cycle (EQF level 7)

0 ; Doctoral or

equivalent third cycle (EQF level 8)

0 Number of students

.

at the receiving institution benefiting from th

e

teaching programm

e:

Number of teaching hours:

Language of instruction: ..

.

..

.

....

..

....

.

..

...

..

.

..

.

..

.

Overall objectives of the mobility:

Added value of the mobility (in the context of the modernisation and

internationalisation strategies of the institutions involved):

Content of the teaching programme:

Expected

outcome~

and impact (e.g. on the professional development of the

teaching staff member and on the competences of students at both

institutions):

(4)

GfNA-11-C-Annex IV-Erasmus+ HE Staff Mobility Agreement for teaching

Erasmus

+

Mob~li~y

Agreement torm

PartiCipant's name

II. COMMITMENT OF THE THREE PARTIES

By signing9 _{this document, the teaching}_staff_{member, the}_send_ing_{institution/enterprise and}_the_receiving

institution confirm that they approve the proposed mobility agreement.

The sending higher education institution supports the staff mobility as part of its modernisation and

internationalisation strategy and will recognise it as a component in any evaluation or assessment of the teaching staff member.

The teaching staff member will share his/her experience, in particular its impact on his/her professional

development and on the sending higher education institution, as a source of inspiration to others.

The teaching staff member and the sending institution commit to the requirements set out in the grant agreement signed between them.

The teaching staff member and the receiving institution will communicate to the sending institution/enterprise any problems or changes regarding the proposed mobility programme or mobility period.

The teaching staff member

Name

:

Siqnature:

The sending institution/enterprise

Name of the responsible

person:

Signatu

r

e:

The receiving institution

Name

of the

responsible

p

erso

n

:

Signatur

e:

Date

:

Date:

1 In case the mobility combines teaching and training activities, this template should be used and adjusted to fit both activity types.

2 _Seniority:_Junior_{(approx. < 10 years o}_f_expe_ri_e_n_ce),_Int_erme_diate_(a_pp_r_ox_._> _{10 and < 20 years of}

experience) or Senior (approx. > 20 years of experience).

' Nationality: Country to which the person belongs administratively and that issues the ID card and/or passport.

' All refererences to "enterprise" are only applicable to mobility for staff between Programme Countries or

within Capacity Building projects.

5 _{Erasmus Code:}_A_unique_ident_i_{fier that eve}_ry_{higher education}_{institution that has}_been_awarded_w_ith_the

Erasmus Charter for Higher Education receives. It is only applicable to higher education institutions located in

Programme Countries.

''Country code: ISO 3166-2 country codes available at: https:/.Lwww.iso.QIQLQQQLui/#search.

The top-level NACE sector codes are available at http: //ec.europa .eu/eurostat/ra mon/nomenclatures/index.cfm ?Tarqeturl = LST NOM DTL&StrNom= NACE R EV2&5trLanguageCode=EN

'The ISCED-F 2013 search tool (available at httQ_:_LL_ec.europa.eu/educatl_QDLtogls/isced-f en.htm.l should be

used to find the ISCED 2013 detailed field of education and training.

' Circulating papers with original signatures is not compulsory. Scanned copies of signatures or electronic signatures may be accepted, depending on the national legislation of the country of the sending institution (in

the case of mobility with Partner Countries: the national legislation of the Programme Country).

(5)

GfNA-11-C-Annex-IV-Erasmus+ HE Staff Mobility Agreement for training

Erasmus

+Mobi_ri~v

Agreement form

Part1c1pant's name

STAFF MOBILITY FOR TRAINING

1 MOBILITY AGREEMENT

Planned period of the training activity: from

[day

/

month

/

year]

till

[day

/

month

/

year]

Duration (days) - excluding travel days:

The Staff Member

Last name (s)

First name (s)

Seniority

2

_Nationality

3

Sex [M

/

F]

Academic year

20 .. /20 ..

E-mail

The Sending Institution

Name

Faculty /Department

Erasmus code

4

_{not applicable}

(if applicable)

Address

Country/

Country code

5

Contact p

e

rson

Contact

person

name and position

e-mail

I

phone

'

The Receiving Institution

1 Enterprise

6

Name

Erasmus code

HRZAGREBOl

Faculty

/

Departm

e

nt

(if applicable)

Address

Country/

HR

Country cod

e

Contact person,

Zeljka Pitner, IRC Contact person

zeljka.

Qitner(O)unizg. hr;

name and position

e-mail

I

phone

00385

1 46 98

105 Type of enterprise

:

Size of enterprise

0 < 250 employees

NACE code

7 (if applicable) _0>25₀_emp_loy_ees

(if applicable)

(6)

Higher Education

Erasmus

+Mobi_li~v

Agreement form

Part1c1pant's name

Section to be completed BEFORE THE MOBILITY

I. PROPOSED MOBILITY PROGRAMME

Language of training:

...

..

...

.

...

.

....

.

..

.

...

.

Overall objectives of the mobility:

Added value of the mobility (in the context of the modernisation and

internationalisation strategies of the institutions involved):

Activities to be carried out:

Expected outcomes and impact (e.g. on the professional development of the

staff member and on both institutions):

(7)

•

E

r

as

mus

+

Mobi_li~y

Agreement torm

PartiCipant's name

II. COMMITMENT OF THE THREE PARTIES

By signing8 _th_{is do}_c_um_e_n_t,_t_{he s}_t_a_ff_{member, the sending}_in_st_it_ution_a_{nd the re}_c_e_i_v_in_g_i_ns_titut_io_n_/e_nt_e_r_pr_i_se

confirm that they approve the proposed mobility agreement.

The sending higher education institution supports the staff mobility as part of its modernisation and

internationalisation strategy and will recognise it as a component in any evaluation or assessment of the staff

member.

The staff member will share his/her experience, in particular its impact on his/her professional development

and on the sending higher education institution, as a source of inspiration to others.

The staff member and the sending institution commit to the requirements set out in the grant agreement

signed between them.

The staff member and the receiving institution/enterprise will communicate to the sending institution any

problems or changes regarding the proposed mobility programme or mobility period.

The staff member

Name:

Signature:

The sending institution/enterprise

Name of the responsible person

:

Signature:

The receiving institution

Name of the responsible person

:

Signature:

Date:

Date

:

Date:

1 _In_case_th_{e mobi}_l_{ity co}_m_b_i_{nes teac}_hi_ng_a_nd_tra_in_ing_ac_t_ivi_t_ie_s_,_{the mobility agreement for teaching}

template should be used and adjusted to fit both activity types.

' Seniority: Junior (approx. < 10 years of experience), Intermediate (approx. > 10 and < 20 years of

experience) or Senior (approx. > 20 years of experience).

3 _Nationality_{: Co}_unt_{ry to w}_hi_c_h_{the pers}_o_{n belongs admini}_st_ra_t_{ively and that is}_s_ues_t_he_ID_ca_r_d_and/or

passport.

'Erasmus Code: A unique identifier that every higher education institution that has been awarded with the

Erasmus Charter for Higher Education receives .. It is only applicable to higher education institutions located

in Programme Countries.

5 _{Country code: ISO}₃₁₆₆_-₂_co_untr_{y codes ava}_il_{able a}_t_:_{b..tl.N.JLwww.iso.o}_r_{g/obp/ui/#search.}

''All refererences to "enterprise" are only applicable to mobility for staff between Programme Countries or

within Capacity Building projects.

7 _Th_e_t_op_-l_evel_NACE_sec_t_o_r_co_d_{es a}_r_{e ava}_il_ab_l_{e at}

http:

II

ec.

europa. ~.Leu rostat/ ramon/_r].Q_IJJ..encJa turesLL8Ji~l<..S.frn7_Tilm~J)Ji=1S.I_tJ 0 M QTLll\_StrNom '=.,['JACE_B

EV.2

&_5

t rl,.<'JD.illLi,lggCQO~:=..fN

8 _C_i_r_cu_latin_g_{papers with original signatures}_i_s_{not compulsory.}_Scanned_copies_of_signatures_{or electronic} signatures may be accepted, depending on the national legislation of the country of the sending institution (in the case of mobility with Partner Countries: the national legislation of the Programme Country).