Academic year 2019-202 0	                                                                                     

REQUEST FOR EXTENTION OF ERASMUS STUDY PERIOD ABROAD

I, the undersigned, _________________________________ (student name) , enrolled in the _____ year for the Degree Course in ________________________________________ Department of___________________________________ at the Università degli Studi “G. d’Annunzio” Chieti-Pescara	REQUEST
for the extention to my Erasmus+ study period in the University of __________________________________ from______________ to_________________ for the following reasons (please specify):
____________________________________________________________________________________________________________________________________________________________________________
Initial period agreed in the contract stipulated with Università degli Studi “G. d’Annunzio” Chieti- Pescara (art: 2.2) From______________________ to____________________________ 
Extension requested (art: 1.5) From___________________________ to______________________ 
(N.B. the initial date of extension period must follow the final date of the initial Erasmus period, without interruption)

        Student’s signature:		                                   Signature of Erasmus Coordinator at Host University		   
__________________________                                                 _____________________________
     (the student accepts the extention
      even without financial support)                                                      Date:_________________
			       
			      Seal of Institution: 
Signature of Erasmus Department Coordinator
at  the Università degli Studi “G. d’Annunzio” Chieti-Pescara
      
 Date:_________________
Note: The student should send the form as a scanned version to uri1@unich.it and bring the original document to the Erasmus Office at the Home Institution (Lo studente dovrà inviare il documento per scansione a uri1@unich.it  e al ritorno consegnare l’orignale all’Ufficio Erasmus dell’Università degli Studi “G. d’Annunzio” Chieti-Pescara

1Support for request of extended Erasmus study periods will be financed at the end of the year on availability of funds from the Erasmus+ National Agency. (Il finanaziamento per le mensilità di prolungamento richieste sarà accordato solo alla fine dell’anno Erasmus, quindi a consuntivo, ed è subordinato alla disponibilità di fondi da parte dell’Agenzia Nazionale Erasmus+).