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@

I nte rnsh ip certifi cate

(Attestation de stage)

Loeo or THE HOST ORGANIZATION

(to6o oE I'ORGAN/SME D'ACCUEIL)

THE HOST ORGANIZATION pRG ANISME D'ACcuEtL)

Name or company n ame (Nom ou Dênon¡nation

Address (Adlesse):

a

Hereby certif¡es thal pert¡r¡e que)

THE INTERN lrE s¡¡or¡nr,

Last name øom):

Address (loresse¡:

4

. email:

,

First name lPréroø.):

INTERNSHIP CERTIFICATE

(ANESTATION

DESTAGE)

úo be issued fo the intem upon the conclusion of the internship

rqßttre au stqiaire à I'issue du stage)

Sex: F D

M tr

Date of Birth

A Sf UOg¡lf OF (title of the training course or higher education cuniculum being followed by the intern):

(ETUDIANT EN (¡ntitulê de la fomation ou du cutsus de I'enseignenent sutrÉríeur suivi par le ou la stagia¡re ))

AT (name of the higher education institution or training organization)

øu s1tNde (nom de t'éþþtissernent d'ense¡gnement

sup$ieur ou de I'orgênßne de foÍmat¡on))'.

has completed an internship as part of his/her studies þeffecftÉunstaseprêvudanstecadredesesêþJæs)

lm gRlsnlp DUR¡tlOt¡ puRËE DU srAGE)

lnternship start and end dates: From ro,)

(Dates de début et de f¡n du stâ('e)

Representing a total duration of

(Repréßentant

une durée totale de)

DD/MM/YYYY.,

,.,

,

To Øu)

DD/MM/VYYY

(Number of months / Number of Weeks) (cross out any inappropriate item)

(Nbre de ttois / Nbrc de Semainæ)

(rayer la mentíon inutile))

The total duration of the internship is assessed in consideration of the actual presence of the student within the organization, subject any authorized time off and leaves of absence granted, as provided under article L.124-13 of the education code (art. L.124-18 of the education code). Each period of at least 7 hours of presence, whether consecutive or othen¡vise, is considered equivalent to one day of internship work, and each period equal to at least 22 days of presence, consecutive or otherwise, is considered equivalent to one month.

&ríode au mo¡ns égale à 22 þuß de présence corsécutfs ou non est considéré canne êquivalente

à un mo¡s.

Torll- nmoutr oF slpEND

pArD To rHE TNTERN

: (M1NTANT DE LA GRATrFtcAfloN

vERsÉE

AU srAGr,A/R,)

ïhe intern has received an internship stipend totaling

(Le stagia¡re a peeu une gratífrcation de stage pour un nontanttotal

de)

The course certiticate is an ¡ndispensable element, for consideration, subjecf to the payment of a fee, of the intemship work in determining retirement benefits. Retirement pensions legislation (Law No. 2014-40 of January 20,

2014) grants sfudenfs whose intemship work is allocated a stipend the

possibility of having such work validated within two calendar quarters, subject

to the payment of a fee. The application is to be made by the student within

the two years of the end of the internship, and requires the presentation of

the intemship certifrcate indicating the total duration of the internship and the total amount of the stipends paid. Specific information regarding the fee to be paid and the procedure to follow may be requested from the Social Security administration (Social Security Code, art. L.351-17 - Education Code, aft.

0.124-9).

L'attestatíon de stage esf lndispersable pour pouvoir, sous /éserue du versetment d'une cotisatíon,

fa¡re prendrc en conpfe /e sfage dans /es d¡olfs à retraite. La lêgislation su les retraites (loi n"2014-40

du 20 janvier 2014) ouvrc aux étudíanß dont le stÐe a été grat¡f¡é la possibil¡é dans la limite de deux f¡lmesÍres, sous réserve du versement d'une cotßation.

de fa¡re val¡dü celui-ci La denande est à kire

par l'étud¡ant dans les deux annêes su¡vant Ia frn du stage et sur prêsentat¡on oiligatoire de

I'attestati1n de stage nent¡onnant la durée totale du stage et le nontant total de Ia gratification

perçue,

Les informations prêcises sur la cot¡sation à veßer et su la prccêdure à sulv/e sont à demander auprès de la sécuritê s^ciale (c1de de la sécur¡té sociale art. L.351-17 - code de l'êducatíon

MADE lN ¡ra,ra1

THls onv THe rru)

Name, position and signature ofthe representative

ofthe host

OfganiZatiOn

Uon, fonct¡on et s¡gnature du rcprêsentant

de t'organ¡sne d'accueil)

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