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Short Term Mobility Bursary Agreement

Please complete this agreement form if you have been successful in your application for a payment towards an international experience through the Short Term Mobility Bursary. Full completion of this form is required to enable processing of your bursary payment.

Acceptance (required)
I am happy for my reflective piece to be shared on the university website and social media (required)

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This form is being used to confirm who wants to take up offered Short Term Mobility Bursary funding. If you have any queries, please e-mail

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at

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