Country. [insert country where ITT is issued]
Country. Primary Phone Number Secondary Phone Number Primary Email Address* Secondary Email Address Receive email notifications?* q Yes q No If not a U.S. Citizen, enter country of citizenship Employment Status: q Employed q Self Employed q Not Employed/Retired Employer Name Health Plan Type: q Single q Family Effective Date of Qualified Health Insurance (mm|dd|yyyy) / / Health Insurance Carrier *By providing an email address and checking the “Yes” box, the account holder represents and warrants that he/she consents and has the ability to receive the electronic delivery of all investment-related, account-related information and notices at the provided email address. Electronic delivery may include, but is not limited to, emailed copies of or internet links to documents in PDF format. Investment-related and account-related information and notices may include, but is not limited to fund prospectuses, tax notices, account statements, confirmations of statements, account access passwords, etc. Account holder’s consent will be in effect until revoked. Account holder may request no-cost written copies of any electronically delivered documents and/or may revoke his/her consent to electronic delivery by contacting Customer Service.
Country. 2.3 The participant shall receive a financial support from Erasmus+ EU funds for _______ months and ______ days [if the participant receives a financial support from Erasmus+ EU funds: the number of months and extra days shall be equal to the duration of the mobility period. If the participant receives a financial support from Erasmus+ EU funds combined with a zero-grant period: the number of months and extra days shall correspond to the period covered by financial support from Erasmus+ EU funds, which shall be provided at least for the minimum duration of the period abroad (2 months for traineeships and 3 months or 1 academic term or trimester for studies)]; [If the participant receives a zero-grant for the entire period: this number of months and extra days should be 0].
Country. You accept and agree to the following terms and conditions for Your present and future Contributions submitted to the Copyright Holders. In return, the Copyright Holders shall not use Your Contributions in a way that is contrary to the public benefit. Except for the license granted herein to the Copyright Holders and recipients of software distributed by the Copyright Holders, You reserve all right, title, and interest in and to Your Contributions.
Country. Student with: ☐ a financial support from Erasmus+ EU funds ☐ a zero-grant The financial support includes (if applicable): Special needs support ☐ The student receives financial support other than Erasmus+ EU funds Institution to complete the following box for all participants receiving financial support from Erasmus+ EU funds. Bank account where the financial support should be paid: Bank account holder (if different than student): Bank name: Clearing/BIC/SWIFT number: Account/IBAN number: Called hereafter “the participant”, of the other part, Have agreed to the Special Conditions and Annexes below which form an integral part of this agreement ("the agreement"): Xxxxx X (b) i: Learning Agreement for Erasmus+ mobility for studies Xxxxx X (b) ii: Learning Agreement for Erasmus+ mobility for Traineeships Learning Agreement for Erasmus+ mobility for Studies combined with a Traineeship Xxxxx X (b) iii: General Conditions Xxxxx X (b) iv: Erasmus+ Student Charter The terms set out in the Special Conditions shall take precedence over those set out in the annexes. It is not compulsory to circulate papers with original signatures for Xxxxx X (b) i and (b) ii of this document: scanned copies of signatures and electronic signatures may be accepted, depending on the national legislation.