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