ERASMUS+ KA171 ICM
CONFIRMATION OF ARRIVAL and DEPARTURE	

	

Please fill in the form and send it to the International Office of Ca’ Foscari University of Venice by email (icm@unive.it).

Academic year	2023/2024	Semester	______	Matriculation number
(Ca’ Foscari)	__________	
Student’s name	______________________	Student’s surname	_____________________________	
Sending institution	Ca’ Foscari University of Venice	Country	_Italy_________________	
Number of months of the Erasmus scholarship	_______________________________________________	

HOST INSTITUTION:
Name and full address	
_______________________________________________________________________________________	
International Relations Officer – name and surname, email	
_______________________________________________________________________________________
	
DATE OF ARRIVAL
at the host institution (dd/mm/yyyy):	___________________________________________	

Student’s signature

__________________________________________
	
International Relations Officer
of the host institution: signature and stamp

_________________________________________
	
Date (dd/mm/yyyy) ___________________________	 Date (dd/mm/yyyy) __________________________	
DATE OF DEPARTURE
from the host institution (dd/mm/yyyy):	___________________________________________	

Student’s signature

__________________________________________
	
International Relations Officer
of the host institution: signature and stamp

_________________________________________
	
Date (dd/mm/yyyy) ___________________________	 Date (dd/mm/yyyy) __________________________