Your personal details
First name *
Last name *
Mr/Ms/Mx *
Ms Mr Mx
Nationality *
Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bonaire, Saint Eustatius and Saba Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Canary Islands Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Cote d Ivoire Croatia Cuba Curacao Cyprus Czech Republic Democratic Republic of the Congo Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran (Islamic Republic of) Iraq Ireland Isle of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Democratic Peoples Republic of Korea, Republic of Kosovo Kuwait Kyrgyzstan Lao Peoples Democratic Republic Latvia Lebanon Lesotho Liberia Libyan Arab Jamahiriya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia (Federated States of) Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin (FR) Saint Pierre and Miquelon Saint Vincent and the Grenadines Saint-Barthélemy Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Sint Maarten (NL) Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Island South Sudan Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syrian Arab Republic Taiwan, Republic of China Tajikistan Tanzania, United Republic of Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Vatican City State (Holy See) Venezuela Viet Nam Virgin Islands (British) Virgin Islands (U.S) Wallis and Futuna Islands Western Sahara Yemen Zaire Zambia Zimbabwe
Date of birth *
Email address 1 *
Email address 2
Employment information
Employee number *
Job title *
Faculty / Interfaculty institute *
Archaeology Governance and Global Affairs Humanities Law Medicine (LUMC) Science Social and Behavioural Sciences African Studies Centre ICLON International Institute for Asian Studies (IIAS)
Research institute / Department *
Seniority *
Junior (less than 10 years experience) Intermediate (10-20 years experience) Senior (more than 20 years experience)
Is this your first Erasmus+ teaching
Contact details receiving institution
Will you teach at a Higher Education Institution?(research university or university of applied sciences) *
Name receiving institution *
Erasmus code receiving institution *
City receiving institution *
Country receiving institution *
Austria Belgium Bulgaria Cyprus Croatia Czechia Denmark Estonia Finland France Germany Greece Hungary Iceland Ireland Italy Latvia Liechtenstein Lithuania Luxembourg Malta North Macedonia Norway Poland Portugal Romania Serbia Slovakia Slovenia Spain Sweden Türkiye French Polynesia (FR) Greenland (DK) New Caledonia (FR) Saint Barthélemy (FR) St. Pierre et Miquelon (FR) Wallis et Futuna Islands (FR)
Name contact person *
Email address contact person *
Details Erasmus+ teaching assignment
Start date - excluding travel *
End date - excluding travel *
Do you need an additional day for travel directly BEFORE *
Do you need an additional day for travel directly AFTER *
Note that the Erasmus+ daily allowance will be calculated on the basis of the duration of your teaching assignment (in days) and the required number of travel days (max. 2).
Do you plan on travelling in a sustainable way? *
If yes, which main mode of transport will you use? *
If no, which main mode of transport will you use? *
Main instruction language *
Bulgarian Czech Danish Dutch English Estonian Finnish French German Greek Hungarian Icelandic Irish Italian Latvian Lithuanian Macedonian Maltese Polish Portuguese Romanian Serbo-Croatian Slovak Slovenian Spanish Swedish Turkish
Field of education code *
0110 Education, not further defined 0111 Education science 0112 Training for pre-school teachers 0113 Teacher training without subject specialization 0114 Teacher training with subject specialization 0119 Education, not elsewhere classified 0188 Education, inter-disciplinary programmes 0210 Arts, not further defined 0211 Audio-visual techniques and media production 0212 Fashion, interior and industrial design 0213 Fine arts 0214 Handicrafts 0215 Music and performing arts 0219 Arts, not elsewhere classified 0220 Humanities (except languages), not further defined 0221 Religion and theology 0222 History and archaeology 0223 Philosophy and ethics 0229 Humanities (except languages), not elsewhere classified 0230 Languages, not further defined 0231 Language acquisition 0232 Literature and linguistics 0239 Languages, not elsewhere classified 0288 Arts and humanities, inter-disciplinary programmes 0310 Social and behavioural sciences, not further defined 0311 Economics 0312 Political sciences and civics 0313 Psychology 0314 Sociology and cultural studies 0319 Social and behavioural sciences, not elsewhere classified 0320 Journalism and information, not further defined 0321 Journalism and reporting 0322 Library, information and archival studies 0329 Journalism and information, not elsewhere classified 0388 Social sciences, journalism and information, inter-disciplinary programmes 0410 Business and administration, not further defined 0411 Accounting and taxation 0412 Finance, banking and insurance 0413 Management and administration 0414 Marketing and advertising 0415 Secretarial and office work 0416 Wholesale and retail sales 0417 Work skills 0419 Business and administration, not elsewhere classified 0421 Law 0429 Law, not elsewhere classified 0488 Business, administration and law, inter-disciplinary programmes 0510 Biological and related sciences, not further defined 0511 Biology 0512 Biochemistry 0519 Biological and related sciences, not elsewhere classifed 0520 Environment, not further defined 0521 Environmental sciences 0522 Natural environments and wildlife 0529 Environment, not elsewhere classified 0530 Physical sciences, not further defined 0531 Chemistry 0532 Earth sciences 0533 Physics 0539 Physical sciences, not elsewhere classified 0540 Mathematics and statistics, not further defined 0541 Mathematics 0542 Statistics 0549 Mathematics and statistics, not elsewhere classified 0588 Natural sciences, mathematics and statistics, inter-disciplinary programmes 0610 Information and Communication Technologies (ICTs), not further defined 0611 Computer use 0612 Database and network design and administration 0613 Software and applications development and analysis 0619 Information and Communication Technologies (ICTs), not elsewhere classified 0688 Information and Communication Technologies (ICTs), inter-disciplinary programmes 0710 Engineering and engineering trades, not further defined 0711 Chemical engineering and processes 0712 Environmental protection technology 0713 Electricity and energy 0714 Electronics and automation 0715 Mechanics and metal trades 0716 Motor vehicles, ships and aircraft 0719 Engineering and engineering trades, not elsewhere classified 0720 Manufacturing and processing, not further defined 0721 Food processing 0722 Materials (glass, paper, plastic and wood) 0723 Textiles (clothes, footwear and leather) 0724 Mining and extraction 0729 Manufacturing and processing, not elsewhere classified 0730 Architecture and construction, not further defined 0731 Architecture and town planning 0732 Building and civil engineering 0739 Architecture and construction, not elsewhere classified 0788 Engineering, manufacturing and construction, inter-disciplinary programmes 0810 Agriculture, not further defined 0811 Crop and livestock production 0812 Horticulture 0819 Agriculture, not elsewhere classified 0821 Forestry 0829 Forestry, not elsewhere classified 0831 Fisheries 0839 Fisheries, not elsewhere classified 0841 Veterinary 0849 Veterinary, not elsewhere classified 0888 Agriculture, forestry, fisheries, veterinary, inter-disciplinary programmes 0910 Health, not further defined 0911 Dental studies 0912 Medicine 0913 Nursing and midwifery 0914 Medical diagnostic and treatment technology 0915 Therapy and rehabilitation 0916 Pharmacy 0917 Traditional and complementary medicine and therapy 0919 Health, not elsewhere classified 0920 Welfare, not further defined 0921 Care of the elderly and of disabled adults 0922 Child care and youth services 0923 Social work and counselling 0929 Welfare, not elsewhere classified 0988 Health and Welfare, inter-disciplinary programmes 1010 Personal services, not further defined 1011 Domestic services 1012 Hair and beauty services 1013 Hotel, restaurants and catering 1014 Sports 1015 Travel, tourism and leisure 1019 Personal services, not elsewhere classified 1020 Hygiene and occupational health services, not further defined 1021 Community sanitation 1022 Occupational health and safety 1029 Hygiene and occupational health services, not elsewhere classified 1030 Security services, not further defined 1031 Military and defence 1032 Protection of persons and property 1039 Security services, not elsewhere classified 1041 Transport services 1049 Transport services, not elsewhere classified 1088 Services, inter-disciplinary programmes
Level of teaching *
ISCED-6 Bachelor ISCED-7 Master ISCED-8 Doctoral
Total number of teaching hours *
Is this a teaching assignment within the context of Una Europa? *
Is this teaching assignment part of a Blended Intensive Programme (BIP)? *
Upload the Mobility Agreement for Teaching
Mobility Agreement for Teaching *
Authorising officer
The Erasmus+ teaching assignment must be approved your authorising officer. This could be your team leader, institute manager, head of department etc.
Upon completion of the teaching assignment:
the authorising officer will be provided with instructions for requesting an internal settlement (LUMC: sending an invoice) for the Erasmus+ grant you will receive a final decision letter with information on how to request the reimbursement of the grant
First name *
Last name *
Job title *
Email address *
Cost centre *
Project code(if applicable)
Declaration applicant
I declare that the authorising officer has approved the teaching assignment. *
I declare that the authorising officer has confirmed that the above-mentioned cost centre (and project code, if applicable) can be used for the payment / reimbursement of the Erasmus+ grant. *
I declare that I have read and understood the terms & conditions of the Erasmus+ grant for teaching assignments , and that the information provided in this form is correct. *
Deadline
This application form needs to be submitted at least 1 month before the start date of your Erasmus+ teaching assignment. The responsibility for providing a complete, correct and signed application lies with the applicant.