annex iii - individual travel report for travel costs and ... · annex iii - individual travel...

ANNEX III - INDIVIDUAL TRAVEL REPORT for travel costs and costs of stay To be filled in by each participant

In case of circular/multiple travels, please fill in separate Individual Travel Reports.

Ref. No P5-03-04 Project No. 586137-EPP-1-2017-1-TH-EPPKA2-CBHE-JP The reference number must correspond to the progressive numbering indicated in the financial statements in the final report

(1) PERSONAL DATA

Surname: Jirasatitsin Forename: Suriya .

Nationality: Thai

Home institution: Prince of Songkla University

Staff position/student year of study at home institution: Lecturer

(2) TYPE OF ACTIVITY (Tick as appropriate)

STAFF STUDENTS

Teaching/training assignment Study period

X Training and retraining purposes Participation in intensive courses

Updating programmes and courses Practical placements, internships in companies,

industries or institutions

Practical placements in companies, industries

and institutions

Participation in short term activities linked to the

management of the project

X Project management related meetings

Workshops and visits for result dissemination purposes

(3) DETAILS OF THE TRAVEL

*Please indicate period of travel from departure to return to place of origin ** If different from Home institution please enclose authorisation from the Agency

***Travel distance in Km (One-way travel using distance calculator:http://ec.europa.eu/programmes/erasmus-plus/tools/distance_en.htm)

from place of departure to location of activities

PERIOD*

From (Depart date)

(dd/mm/yy)

To (Return date)

(dd/mm/yy)

08/09/18 17/09/18

PLACE OF

DEPARTURE**

HOME INSTITUTION Prince of Songkla University

COUNTRY THAILAND CITY SONGKHLA

PLACE OF

DESTINATION/

LOCATION OF

ACTIVITY

HOST INSTITUTION UNIVERISITY OF MINHO

COUNTRY PORTUGAL CITY GUIMARAES

TRAVEL DISTANCE***

Km 11,024

(4) DETAILS OF THE ACTIVITY

DATES (excluding travel) From (date): 10/09/18 To (date): 15/09/18

DESCRIPTION OF ACTIVITY(IES) PERFORMED (brief description of the activities performed)

Attended in Campus and Lab Visits on Sept 10, 2018. Participated in the WP #2, 3 & 5 Meeting and

WPs report on Sept 11, 2018. Participated in Industry Meeting on Sept 12, 2018. Attended and

participated in PBL training between Sept 12 – 15, 2018.

SIGNATURE OF THE PARTICIPANT

I hereby declare that I have been carrying out the above-mentioned activities.

Date: 27/09/18 Signature:

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