Application for refund of travelling expenses during Erasmus+/freemover mobilities


I would like to apply I ask for a financial contribution regarding the travel expenses associated
with participation in the mobility programme

………………………………………………………………………………………………………..


Name and surname


UČO


Study programme and the year you are in


Contact address


Place of the stay abroad


Academic year

                                        20 …  /  20 …

Duration of the stay abroad

                                        from…

                                              to …


Travel expenses from your residence ……………………….………


to the place of the stay abroad ………………………………..

Number of tickets


Price of the individual tickets in original currency




Travel expences from the place of the stay abroad ……………………….……….


to your residence  ………………………………..

Number of tickets


Price of the individual tickets in original currency




TOTAL COSTS




NOTE:
  * The application that is not signed by the student cannot be settled
  * Glue the tickets on a separate piece of paper so that their dates and prices are clearly
visible. The refund can be applied only to the way there and back (tickets have to have a date in
compliance with the beginning and end of the stay abroad).
  * Seat reservations, baggage, and journey by private car are not refunded.





In Brno, on ...................................... (date)




.........................................................


Student’s signature








..………………………………………..

Dean’s Office responsible person’s signature:








..………………………………..

Vice-Dean’s decision