Student
 	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	
	Ivane Javakhishvili Tbilisi State University		N/A	1, Ilia Tchavtchavadze Avenue, 0179 Tbilisi	Georgia	შესაბამისი  ფაკულტეტის ხარისხის უზრუნველყოფის სამსახურის უფროსის ან/და პროგრამის ხელმძღვანელის საკონტაქტო ინფორმაცია	
Receiving Institution
 	Name	Faculty/ Department	Erasmus code (if applicable)	Address	Country	Contact person name; email; phone	
	Ca’ Foscari University of Venice, Italy		I  VENEZIA01	Dorsoduro 3246 – 30123 Venezia	Italy	International Office – international.cooperation@unive.it- +39 041 2348054, 7521	

Before the mobility
	
 	Proposed study programme at the Receiving Institution

Planned period of the mobility: from [month/year] February, 2016 to [month/year] July, 2016 (6 months)
	
Table A
Before the mobility	Component code
(if any)	Component title at the Receiving Institution
(as indicated in the course catalogue) 	Semester 
[e.g. autumn/spring; term]	Number of ECTS credits (or equivalent) to be awarded by the Receiving Institution upon successful completion	

 	 	 	 	 	

					
 	 	 	 	Total: …	
Web link to the course catalogue at the Receiving Institution describing the learning outcomes: http://www.unive.it/data/9639	

The level of language competence  in ________     ________                 [indicate here the language/s 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 ☐	

 	Recognition at the Sending Institution
	
Table B
Before the mobility	Component code 
(if any)	Component title at the Sending Institution
(as indicated in the course catalogue) 	Semester 
[e.g. autumn/spring; term]	Number of ECTS credits (or equivalent) to be recognised by the Sending Institution	

 	 	 	 	 	

					
 	 	 	 	Total: …	

									
Commitment  
By signing this document, the student, the Sending Institution and the Receiving Institution confirm that they approve the Learning Agreement and that they will comply with all the arrangements agreed by all parties. Sending and Receiving Institutions undertake to apply all the principles of the Erasmus Charter for Higher Education relating to mobility for studies (or the principles agreed in the Inter-Institutional Agreement for institutions located in Partner Countries). The Sending Institution and the student should 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 commits to 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 the Receiving Institution will communicate to the Sending Institution any problems or changes regarding the study programme, responsible persons and/or study period.	
Commitment	Name	Email	Position	Date	Signature	
Student		
	Student			
Responsible person at the Sending Institution			Study programme Coordinator 			
Responsible person at the Sending Institution			Erasmus+ Scientific Coordinator			
Responsible person at the Receiving Institution