THIS FORM IS ONLY FOR TESTING AND ONLY FOR INTERNAL EUROPEAN COMMISSION / NATIONAL AGENCIES USE. PLEASE DO NOT DISTRIBUTE!

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1 THIS FORM IS ONLY FOR TESTING AND ONLY FOR INTERNAL EUROPEAN COMMISSION / NATIONAL AGCIES USE. PLEASE DO NOT DISTRIBUTE! VIRONMT: ACC A. GERAL INFORMATION Please send this report duly completed and signed to your National Agency within 60 days after the final end date of the action. Once this report and the supporting documents are submitted and approved, the National Agency will either pay the balance of the grant or recover any unspent funds. B. SUBMISSION Programme Sub-programme Action type Action LIFELONG LEARNING PROGRAMME LEONARDO DA VINCI MOBILITY LEONARDO DA VINCI IVT (Initial Vocational Training) Call 2012 Report Type FINAL (Final) B.1. PERIOD COVERED From To B.2. PROJECT IDTIFIERS Grant agreement no. Project title (national language) National id (if applicable) Beneficiary name ES1-LEO Project title National id Full legal name Submission id Form hash code 9A608AC677175D84 Page 1 of 20

2 B.3. NATIONAL AGCY Identification Postal address address Helpdesk Website ES1 LLP (OAPEE) Organismo Autónomo Programas Educativos Europeos - Leonardo, C/ General Oraá, 55, 1ª planta Madrid Page 2 of 20

3 C. IDTIFICATION OF THE BEFICIARY C.1. BEFICIARY ORGANISATION Full legal name (national language) Full legal name (latin characters) Acronym National id (if requested by the NA) Type of organisation Commercial orientation Scope Legal status Economic sector Full legal name Full legal name Acronym National id Association of professors and researchers (ASC-RES) For profit (P) local (L) private (PR) A - AGRICULTURE, FORESTRY AND FISHING Size (staff) staff 1 to 20 Legal address Postal code City Region Legal address Postal code City AT - AUSTRIA AT11 - Burgenland (A) Telephone Telephone Fax Website C.1.1. CONTACT PERSON Title First name Title FIRST NAME Page 3 of 20

4 Family name Department Position Work address Postal code City Region LAST NAME Department Position Work address Postal code City AT - AUSTRIA AT11 - Burgenland (A) Telephone Telephone Mobile Fax C.1.2. PERSON AUTHORISED TO SIGN THE GRANT AGREEMT Title First name Family name Organisation Department Position Work address Postal code City Region Title FIRST NAME LAST NAME Organisation Department Position Work address Postal code City AT - AUSTRIA AT11 - Burgenland (A) Page 4 of 20

5 Telephone Telephone Mobile Fax C.1.3. BACKGROUND/EXPERICE Has a Certificate been granted to your organisation? Yes NO. OF LEONARDO MOBILITY CERTIFICATE Page 5 of 20

6 C.2. PARTNER ORGANISATION Full legal name (national language) Full legal name (latin characters) National id (if requested by the NA) Type of organisation Commercial orientation Scope Legal status Economic sector Full legal name Full legal name National id Association of professors and researchers (ASC-RES) For profit (P) local (L) private (PR) A - AGRICULTURE, FORESTRY AND FISHING Size (staff) staff 1 to 20 Legal address Postal code City Region Legal address Postal code City AT - AUSTRIA AT11 - Burgenland (A) Telephone Telephone Fax Website C.2.1. CONTACT PERSON Title First name Family name Organisation Title FIRST NAME LAST NAME Organisation Page 6 of 20

7 Department Position Work address Postal code City Region Department Position Work address Postal code City AT - AUSTRIA AT11 - Burgenland (A) Telephone Telephone Mobile Fax Page 7 of 20

8 C.3. PARTICIPANTS FIRST NAME FAMILY NAME DATE OF BIRTH GDER TYPE OF PARTICIPANT SPECIAL NEEDS? FIRST NAME LAST NAME 01/01/2000 Male Active adult education teach No C.4. ACCOMPANYING PERSONS FIRST NAME FAMILY NAME DATE OF BIRTH GDER FIRST NAME LAST NAME 01/01/2000 Female C.5. PARTICIPANTS SUMMARY No. of Participants without special needs 1 No. of Participants With Special Needs 1 No. of Accompanying persons 1 Page 8 of 20

9 D. PROJECT DESCRIPTION D.1. SUMMARY Provide a brief summary of the main aims, content and planned outcomes of your project, including an assessment on the level of matching between the initial aims and the final outcomes. Explain shortly also the learning outcomes of the participants and the validation and recognition of them. D.2. ESTIMATED RESULTS, OUTCOMES Explain the results and outcomes for the different parties involved (participants, sending, hosting, intermediary organisations and experts). D.2.1. PROJECT PARTNERS Please describe the outcomes and benefits for the project partners in terms of the organisation's trans-national capacity, vocational training quality improvements, and other aspects. In case you applied elements of ECVET include information on the Memorandum of Understanding or other relevant procedures. D.2.2. INDIVIDUAL PARTICIPANTS Please describe the learning outcomes for individual participants in terms of knowledge, skills and competences (related to professional skills but also key competences such as linguistic, behavioural, intercultural, problem solving, team work building, use of ICT, etc). Please use concrete examples and cases to highlight your answer. D.2.3. PROFESSIONALS IN VET Please describe (if applicable) the outcomes for professionals in VET in terms of knowledge, skills and competences (related to training systems knowledge enhancement, good practice transfer in training provision, professional skills but also key competences such as VET field linguistic knowledge acquisition, ICT know-how, etc.). Page 9 of 20

10 D.2.4. OTHER RESULTS Please describe here any additional relevant information. D.3. IMPACTS Please describe the wider impact of the project at the sectorial, regional, national and European level (where applicable). D.3.1. SECTORIAL DEVELOPMT Promoting development and cooperation with VET-fields, economic sectors, cooperation between enterprises and training institutions, covering qualification needs in an economic sector. D.3.2. REGIONAL DEVELOPMT Promoting regional development and cooperation. D.3.3. OTHER ESTIMATED IMPACTS Please describe here any additional relevant information on for example national or European impacts of your actions. Page 10 of 20

11 E. MOBILITIES' INFORMATION E.1. PARTICIPANTS' MOBILITIES Mobility No. Participant Economic Sector Field of education Level of education Sending 1 FIRST NAME LAST NAME A - AGRICULTURE, FORESTAccounting and taxation (3ISCED 0 - Pre-primary AT - AUSTRIA BE - BELGIUM Mobility No. 1 Participant FIRST NAME LAST NAME E.1.1. USED LANGUAGES Mobility No. Sending Intermediary Sending Departure date Return date (weeks) Sending AT - AUSTRIA BE - BELGIUM 01/01/ /02/ Participant Language 1 FIRST NAME LAST NAME BG - Bulgarian E.1.2. MOBILITIES' CERTIFICATIONS/RECOGNITIONS (days) Mobility No. Participant Organisation (Sending, Hosting or Intermediary Recognition / Certification Type 1 FIRST NAME LAST NAME Certifications (CERT) E.2. ACCOMPANYING PERSONS' MOBILITIES Mobility No. Accompanying Person Sending Intermediary Sending Departure date Return Date (weeks) 1 FIRST NAME LAST NAME AT - AUSTRIA BE - BELGIUM 01/01/ /02/ E.3. MOBILITIES SUMMARY (days) Page 11 of 20

12 Sending country country No. Participants No. Accompanying Persons Total (weeks) Total (days) AT - AUSTRIA BE - BELGIUM Page 12 of 20

13 F. PROJECT DISCREPANCIES SUMMARY F.1. PARTICIPANTS' REPORTS STATUS Project Total Number of Participant Mobility Experiences Out of which have a Submitted and Approved Participant Report 1 0 Please provide any suitable explanations regarding the fact that not all participant reports were submitted and approved at the moment of submission of this final report. F.2. PARTICIPANTS WITHOUT MOBILITIES F.2.1. PARTICIPANTS FIRST NAME FAMILY NAME DATE OF BIRTH GDER TYPE OF PARTICIPANT SPECIAL NEEDS? FIRST NAME LAST NAME 01/01/2000 Female Active adult education teach No F.2.2. ACCOMPANYING PERSONS FIRST NAME FAMILY NAME DATE OF BIRTH GDER FIRST NAME LAST NAME 01/01/2000 Male Please provide any suitable explanations regarding the fact that these participants have no mobilities assigned to them. Page 13 of 20

14 F.3. MOBILITY EXPERICES WITH A SHORTER THAN ALLOWED DURATION F.3.1. PARTICIPANTS Mobility Participant No. FIRST NAME LAST 1 NAME F.3.2. ACCOMPANYING PERSONS Mobility No. Accompanying Person Sending Intermediary Sending Departure date Return date (weeks) Full legal name Full legal name Full legal name AT - AUSTRIA BE - BELGIUM 01/01/ /02/ Sending Intermediary Sending Departure date Return Date (weeks) 1 FIRST NAME LAST NAME Full legal name Full legal name Full legal name AT - AUSTRIA BE - BELGIUM 01/01/ /02/ Please provide any suitable explanations regarding the fact that these mobilities have a shorter duration. (days) (days) F.4. MOBILITIES WITH ZERO BUDGET F.4.1. PARTICIPANTS Mobility No. 1 Participant FIRST NAME LAST NAME F.4.2. ACCOMPANYING PERSONS Sending Intermediary Sending Departure date Return date (weeks) Full legal name Full legal name Full legal name AT - AUSTRIA BE - BELGIUM 01/01/ /02/ (days) Page 14 of 20

15 Mobility No. Education and Culture DG Accompanying Person Sending Intermediary Sending Departure date Return Date (weeks) 1 FIRST NAME LAST NAME Full legal name Full legal name Full legal name AT - AUSTRIA BE - BELGIUM 01/01/ /02/ Please provide any suitable explanations regarding the fact that these mobilities have a zero budget. (days) G. FUNDING G.1. OTHER FUNDING SOURCES If applicable, please identify other funding sources for the project other than Leonardo da Vinci. G.2. MOBILITY ORGANISATION AND MANAGEMT Total No. of Participants 1 Total G.3. PEDAGOGICAL, LINGUISTIC AND CULTURAL PREPARATION Participant Total Page 15 of 20

16 Participant Total FIRST NAME LAST NAME Total No. of Participants 1 Pedagogical, linguistic and cultural preparation total G.4. MOBILITIES G.4.1. PARTICIPANTS Mobility No. Participant Special Needs? Sending Destination country Travel Cost (weeks) Subsistence (days) Subsistence Travel + Subsistence 1 FIRST NAME LAST NAME No AT - AUSTRIA BE - BELGIUM G.4.2. ACCOMPANYING PERSONS Mobility No. Accompanying Person Sending Destination country Travel Cost (weeks) Subsistence (days) Total Travel + Subsistence 1 FIRST NAME LAST NAME AT - AUSTRIA BE - BELGIUM G.4.3. MOBILITIES SUMMARY Sending No. Participants without No. Participants with No. Travel Cost Subsistence Travel + Page 16 of 20

17 special needs special needs Accompanying Persons (weeks) (days) Total Subsistence AT - AUSTRIA BE - BELGIUM Page 17 of 20

18 G.5. SUMMARY Total Mobility Organisation and Management Pedagogical, linguistic and cultural preparation Participants without special needs Travel Participants With Special Needs 0.00 Mobility Accompanying persons Participants without special needs Subsistence Participants With Special Needs 0.00 Accompanying persons Total National funds Other Funds Own contribution 0.00 Other sources 0.00 Total Page 18 of 20

19 H. DATA PROTECTION NOTICE PROTECTION OF PERSONAL DATA The grant application will be processed by computer. All personal data (such as names, addresses, CVs, etc.) will be processed in accordance with Regulation (EC) No 45/2001 of the European Parliament and of the Council of 18 December 2000 on the protection of individuals with regard to the processing of personal data by the Community institutions and bodies and on the free movement of such data. Information provided by the applicants necessary in order to assess their grant application will be processed solely for that purpose by the department responsible for the programme concerned. On the applicant's request, personal data may be sent to the applicant to be corrected or completed. Any question relating to these data, should be addressed to the appropriate Agency to which the form must be submitted. Beneficiaries may lodge a complaint against the processing of their personal data with the European Data Protection Supervisor at anytime. I. BEFICIARY DECLARATION AND SIGNATURE I, the undersigned, hereby declare that the attached information is accurate and in accordance with the facts. In particular the financial data provided in this report correspond to the activities actually realised and to the grants actually paid for subsistence, travel and preparation of participants. Place: Date: Name: Position within the contracting organisation: Signature: Page 19 of 20

20 J. SUBMISSION Before submitting the form electronically, please validate it. Please note that only the final version of your form should be submitted electronically. J.1. DATA VALIDATION Validation of compulsory fields and rules J.2. SUBMISSION SUMMARY This table provides additional information (log) of all form submission attempts, particularly useful for the National Agencies in case of multiple form submissions. Number Time Event Form hash code Status :00:14 * Form has not been submitted yet 9A608AC677175D84 Unknown * means local PC time, which is not trusted and cannot be used for claiming that the form has been submitted in time J.3. STANDARD SUBMISSION PROCEDURE Online submission (requires internet connection) J.4. ALTERNATIVE SUBMISSION PROCEDURE Creates a file to be sent by to the National Agency (To be used ONLY if online submission is not available. Please see instructions about this procedure in the "Applicant Guide") Page 20 of 20

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