Lifelong Learning Programme Leonardo da Vinci



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Lifelong Learning Programme Leonardo da Vinci PLACEMET REPORT MYSELF (PRE-FILLED BY SYSTEM) Surname First name M / F Date of Birth Country of resence Target group Level of studies MY SEDIG ORGAISATIO (PRE-FILLED BY SYSTEM) Country ACE activity Project number MY ITERMEDIARY ORGAISATIO (PRE-FILLED BY SYSTEM) (Intermediary organisation: training institution you attended - or any other organisation - that selected the firm where your placement took place) ACE activity MY HOST ORGAISATIO(S) (PRE-FILLED BY SYSTEM) ACE activity

MY PLACEMET (PRE-FILLED BY SYSTEM) Destination country Departure date Return date Duration (in weeks) Recognition Languages used PREPARATIO Language preparation received enabled me to cope Mark 1 to 5 + comments with everyday situations Language preparation received helped me to work in my occupational area I received the necessary information to get integrated into my new environment OVERALL SATISFACTIO REGARDIG PREPARATIO Describe what preparation was proved: linguistic courses, information about the host country and its culture, work organisation, COTET I was given proper help to find a suitable host Mark 1 to 5 + comments organisation The organisation where I trained/worked met my training needs I knew clearly what I was expected to do and learn during my placement abroad The placement duration was long enough for me to fulfil my training objectives Proposed activities were directly related to my training / training objectives in my home country I was proved with proper equipment I knew who the person assigned to help me carry out my programme and check my results was My sending school/organisation was helpful during my placement OVERALL SATISFACTIO REGARDIG MY WORK PLACEMET

Explain how your sending and host organisation prepared and organised your work placement. Were you involved in the work placement preparation? Prove description of the host organisation, everyday activities, specific tasks undertaken, contact persons in charge (both in sending and receiving organisations), RECOGITIO I received certification from my host organisation Y I received certification from the organisation that Y arranged my placement I received a certificate from my sending Y organisation My placement was an integral part of the Y qualification that I am/was studying I was awarded a Europass-Training document Y OVERALL SATISFACTIO REGARDIG RECOGITIO OF Mark 1 to 5 + comments MY WORK PLACEMET Your personal comments : OUTCOMES I discovered new techniques, new methods I have new professional skills I can express myself better in another language I feel more confent I now have a better understanding of other people I m more interested in my training than before I now conser working in another country My placement abroad will help with my future studies* (only for persons still in training) My placement abroad will help me find a job Mark 1 to 5 + comments

Describe the benefits you have gained from your work placement abroad and the impact you expect on your professional/personal life PRACTICAL ARRAGEMETS I am satisfied with the grant proved by the Mark 1 to 5 + comments Leonardo programme for accommodation and subsistence I am satisfied with the arrangements for transportation I am satisfied with the arrangements for insurance I am satisfied with the information I received concerning my social protection I am satisfied with the information and support I received concerning my personal safety? I am satisfied with the assistance I received concerning the practicalities of training/working abroad I completed and understood a contract with my yes/no host/sending/intermediary organisations regarding my work placement I was offered opportunities to be integrated into local life The host enterprise pa me a gratuity Y OVERALL SATISFACTIO REGARDIG SUPPORT FROM Mark 1 to 5 + comments SEDIG ORGAISATIO FOR PRACTICAL ARRAGEMETS OVERALL SATISFACTIO REGARDIG SUPPORT FROM HOST ORGAISATIOS FOR PRACTICAL ARRAGEMETS OVERALL SATISFACTIO REGARDIG FIACIAL SUPPORT PROVIDED BY THE LEOARDO DA VICI PROGRAMME Describe what practical arrangements were taken for your stay abroad: travel, insurance, accommodation, local transportation, With regards to the above, explain how the finances were organised and, if applicable, explain the problems encountered and what solutions were found. Describe what you d in your free time.

RECOMMEDATIOS FOR OTHER PARTICIPATS RECOMMEDATIOS FOR IMPROVIG THE PROGRAMME I herewith join the requested supporting documents for my expenses during my placement for the purpose of determining the final balance of my grant. Date Signature