DECLARATION ON HONOUR

It is hereby declared that:

Name: ……………………
Surname: ………………..
Matriculation number:………………..
Selected for an Erasmus+ mobility for studies at (please, indicate the host university name)
……………………………………………….
employed sustainable means of transport for most of his/her round trip to and from the Erasmus+ destination.

Main means of transport employed (please, select one option):

 train

 bus

 car pooling

 bike

 other, PLEASE SPECIFY ………

SIGNATURES

The Participant	            			           For the Organisation

Name and surname 	Dott. Mauro Cannone, on behalf of the                         Rector Prof. Tiziana Lippiello

_________________________________ 		 ______________________________	

[signature]						[signature]

[Place and date]						Venice