Mobility Report: STUDENT REPORTAcademic Year: _________________

Please indicate:

CEEPUS Network Number (CPnr.):___________________________Or FreemoverDear CEEPUS Student!Your feedback is very important for CEEPUS, so please forward this report to your National CEEPUS Office (NCO) within two weeks after returning from your host country or as advised by your National CEEPUS Office! - Thank you!

Contact Addresses: National CEEPUS OfficesWWW.CEEPUS.INFO

1. Basic Personal Data:

1.1 Personal Data

academic degree: first name: last name: sex: male femaledate of birth: citizenship:

1.2 Country of origin: please tick appropriate box:= country of your home institution

Austria Poland Bulgaria Slovakia Croatia Slovenia Hungary1.3 Host country : please tick appropriate box:multiple entries if necessary Austria Poland Bulgaria Slovakia Croatia Slovenia Hungary

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1.4 Period of Stayas in your Letter of Confirmation

from: (dd/mm/yy) ______to: (dd/mm/yy):______in: (host country):______________from: (dd/mm/yy) ______to: (dd/mm/yy):______in: (host country):______________from: (dd/mm/yy) ______to: (dd/mm/yy):______in: (host country):______________

1.4.1 Prolongation: Was your CEEPUS grant prolonged? please tick appropriate box yes no

1.4.2 Duration: Total in scholarship months (incl. prolongation where applicable)

please tick appropriate box1 2 3 4 5 6 7 8 9 10 11 12

1.5 Field of Study (Index copyright SAIA Slovenska)*please mark the appropriate box according to your general field of study

o 140000 EDUCATION & TEACHER TRAINING

o 180000 FINE & APPLIED ARTS

o 220000 HUMANITIES

o 260000 RELIGION & THEOLOGY, GENERAL

o 300000 SOCIAL & BEHAVIOURAL SCIENCES

o 340000 BUSINESS ADMINISTRATION & MANAGEMENT

o 380000 LAW

o 420000 NATURAL SCIENCES

o 460000 MATHEMATICS & COMPUTER SCIENCE

o 500000 MEDICAL SCIENCES

o 520000 TECHNOLOGY

o 540000 ENGINEERING

o 580000 ARCHITECTURE & TOWN PLANNING

o 620000 AGRICULTURE, FORESTRY & FISHERY

o 660000 HOME ECONOMICS (DOMESTIC SCIENCE)

o 700000 TRANSPORT & COMMUNICATIONS

o 780000 SERVICE TRADES

o 840000 MASS COMMUNICATION & INFORM. SCIENCES

o 890000 SECURITY & RECREATION

1.6 Local Denomination of your Field of Study (in English)

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1.7 Student Progress

When consuming my CEEPUS grant, I was in my ______________semester.

2. Studying Abroad

2.1 Host Institution:

university: faculty/institute: country:

where applicable also second host institution:university: faculty/institute: country:

2.2 Activities: Lectures and CoursesPlease list the lectures/courses attended:Note: You may add another sheet of paper

Title Type of Instruction

Language of Instruction

hrs perweek

exam passed:yes/no

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2.3 Activities: Other types of instructionplease tick appropriate box, multiple entries are possible

I have participated in/attended:

Laboratory work Practical training Worked on my thesis Summer School other activities:please specify: _________________________________________________

2.4 Integration: please tick appropriate box

2.4.1 Did you feel well integrated during your stay in the host country: academically yes no

(i.e. assistance in finding your way at the host institution, tutoring or similar activities?) socially yes no (e.g. buddy network)?

2.4.2 Were there any special activities to encourage integration? yes noif yes, please specify:

2.5 Organizational details: please tick appropriate box

2.5.1: Preparation:Did you encounter any difficulties while preparing for your period of studying abroad?

no yesif yes, please specify: (keywords)

2.5.2 Payment of Scholarship: AgencyBy which agency/institution was your scholarship paid?

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2.5.3 Payment of Scholarship: IntervalsAt which intervals was your scholarship paid?

monthly weekly other interval:__________

2.5.4 Optional Funding:Did you receive any additional CEEPUS funding/fringe benefits by authorities or institutions in your home country and/or your host country? yes no

if yes, please specify:

travel allowance others, please specifiy:

2.5.5: FeesDuring your stay at your host institution, were you charged any fees?

no yesmultiple entries possibleif yes, please specify: registration fees tuition fees laboratory fees other fees:______________

2.5.6 Accommodation: PreparationUpon arrival at your host institution, how did you arrange for accommodation?multiple entries possible accommodation was arranged by host institution checked local market with assistance of:_______________ checked local market alone other arrangement:________________________________

2.5.7 Accommodation: TypeWhich type of accommodation did you use: multiple entries possible

student hostel hotel youth hostel private room private flat shared with other students guest house private flat alone other type of accommodation: _______________3. After your return:

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3.1 Recognition please tick appropriate box

Did you have any difficulties in obtaining recognition of your period of studying abroad?

no yes

if yes, please specify:

3.2 Knowledge of Languages please tick appropriate box

Was there any improvement in your language skills?

yes no

if yes, grade your skills - after your return - on the table below: (0 = not at all, I = basic, II= intermediate, III=fluent)

01

I II III 0 I II III 0 I II III

English Bulgarian Polish

German Croatian Slovenian

French Czech Slovak

Hungarian

3.3 Possible Difficulties please tick appropriate box

Did you encounter any difficulties? no yes

If yes, what were your biggest difficulties?

1 0 = not at all, I= basic, II= intermediate, III=fluent. Please note: If you do not mark any box, "0" no competence will be assumed: Please indicate all boxes!

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3.4 Possible improvements If you have suggestions for improvement, please let us know:

3.5 Network PerformanceIf you could rate the performance of your network, which grades would you give for overall performance:

excellent ok room for improvement

How did you arrive at this conclusion, which criteria did you apply?

3.6 Assistance for future CEEPUS students please tick appropriate box

Would you be interested in sharing your CEEPUS know-how with future students?

yes no

3.7 Best memoryWhat is the best memory of your CEEPUS experience?

I agree to electronic processing of the data provided

Signature: _______________________________ Date:____________________

THANK YOU FOR YOUR COOPERATION!!!

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