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TRANSCRIPT
Confirmation of Departure 2017/2018
Our Ref:
Student Details
Student Surname
Student first Name
Date of Birth
Mobility Type
Host Organisation
Start Semester
Duration in Semesters
Host Organisation Signatory Details
Surname
First Name
Position
Department
I, the above mentioned signatory confirm that the student, , will depart our
organisation on the______________________ (date).
The final duration has been a total of ________ months.
Stamp:
Signature____________________________________
Date____________________________________
Please note:
1. This form should be completed by your contact just before you depart the host organisation.
2. Please ask your contact for the earliest date this form will be completed for you.
3. The form must be completed in full, incomplete forms will be returned.
4. The end date should be a date of the last day of exams, or final assignments submitted.
5. The end date can positively or negatively influence the final grant amount you will receive.
6. Please ensure the date that is entered is your final date in the host organisation, as this cannot be amended later.
7. Completed forms should be submitted
a. in PDF or Word format by email to [email protected] only
b. Hard copies sent to DIT International Office, 40-45 Mount Joy Sq, Dublin 1