Work Placement Agreement Article 1. The current agreement is between the company (or organisation) designated below: Name of the host company or organisation: Address of the premises at which the student will be working: Country: Company s field of expertise: Telephone number: Fax number: Company registration number (if required): Represented by: Name: e-mail: Position: And the university: Name and address: La Faculté Libre des Sciences Economiques et de Gestion - Institut Catholique de Lille, 60 boulevard Vauban 59000 Lille France Telephone number: Fax number: Represented by: And concerns the student named below whose attention has been drawn to the terms of the agreement and whose signature appears at the end of the agreement: First name: Date of birth: Section: Last name: Nationality: Current year of studies: Home address:
Article 2. Assignment The trainee will be assigned the following responsibilities:.... Article 3. Duration* of the work placement Full- time For a period of weeks, from to Part-time For a period of weeks, from..to.. The student will be required to attend lectures at the university on the following days/dates. The student will be required to be present in the company on the following days/dates.. *Tick the appropriate box and fill in where necessary. Article 4. Working hours The trainee is subject to the legal daily and weekly working hours in force in the host country which are... He/She may be required to work: At night Sundays Bank Holidays Article 5. Supervision For the duration of the work placement, the company will designate a member of staff who undertakes to supervise and monitor the student s progress. The representative of the faculty is at the disposal of the student and the company to provide any assistance to ensure the objective of the trainee s work is met and may enquire at any time as to the well-being and progress of the student. If necessary he may visit the student in the workplace on prior arrangement with the company. Article 5: Evaluation The objective of the training period is to provide the student with the opportunity to gain practical professional experience related to his/her area of study. It is a compulsory part of the student s course and will be taken into account to evaluate the student s knowledge and aptitudes. On completion of his/her work placement the student will write a report to be submitted to both the academic tutor and the host company. In the event of any information needing to remain confidential, the host company may request that distribution of the report be strictly limited to those professors directly concerned. At the end of the training period the head of the host company will supply the faculty with an evaluation of the trainee s work and behaviour. The student may be required to present his/her work placement orally before members of the academic staff in which case a representative of the host company will be invited to attend.
Article 7. Certificate The host company undertakes to provide the trainee with a certificate testifying as to the nature and length of the training period if requested. Article 8: Payment For all work placements lasting over a period of 3 months, the student may claim an allowance from the company to contribute towards living expenses. The amount of this allowance is at the company s discretion. For the purposes of this work placement the company undertakes to provide the student with the following allowance......... Article 9: Fringe benefits During his/her work placement the student may benefit from a range of fringe benefits offered by the host company (meals, company accommodation.) For this work placement the fringe benefits include Article 10: Professional Expenses The host company undertakes to reimburse any expenses incurred by the student for professional reasons and with the prior agreement of the company, upon presentation of the appropriate justification. Article 11: Health Insurance cover. During their work placements, trainees remain affiliated to the social security scheme covering students and will be entitled to claim sickness benefit, maternity benefits as well as family allowance. If the student was not previously covered by this student scheme he/she will nevertheless be covered in the event of illness as long as he/she has the necessary status as stipulated in article 285 of the Code de la Sécurité Sociale. Article 12: Insurance cover for accidents at work The student also continues to benefit from French legislation on accidents at work (article 412-8, 2, paragraph b, of the Code de la Sécurité Sociale. In the event of an accident occurring either in the workplace or on the journey to or from work, the company will inform the contact person at the university as soon as possible who will in turn carry out the necessary formalities with regard to the official declaration. The company declares it is insured for third party risk or undertakes to take out insurance cover Article 13: Damage Damage that occurs outside of the host company and during activities that are external to the work is not covered by legislation on accidents at work. In this case the student will be covered by insurance taken out by the Institut Catholique de Lille for both the damage caused by students and any damage that they may suffer from. Article 14: Amendment of working hours for academic purposes A part of his/her studies, the student may be required to sit/resit exams or attend selection interviews. The company will allow the trainee to modify his /her working hours/days to enable him/her to fulfil his/her academic obligations. The student undertakes to inform the company preferably before the start of the work placement of any possible absences.
Article 15: Termination of the work placement The trainee is subject to general rules applying in the host company or organisation, particularly with regard to safety, discipline and working hours. Should the trainee not respect these rules, the company reserves the right to terminate the work placement after having notified the head of the faculty in writing. Article 16: Number of copies 3 copies of the present agreement are to be signed by the company, the University and the student. 1. For the company Signature and stamp Date : 2. For the faculty Date: Signature and stamp 3. The trainee Date: Signature : Social security number: Social security centre:
Protection sociale en cas de stage à l étranger Merci de prendre connaissance de ce document et de le retourner signé en même temps que votre convention de stage si vous effectuez ce stage à l étranger. Aucune convention pour l étranger ne sera signée sans que ce document le soit au préalable Pour les stages au sein de l espace économiques européen (EEE) effectués par des étudiants de nationalité d un des pays membre de l union européenne, il faut demander la carte européenne d Assurance Maladie (CEAM) auprès de votre caisse primaire d assurance maladie. Vous trouverez plus d information sur le site de l assurance maladie www.ameli.fr. Pour les stages effectués au Québec par les étudiants de nationalité française, il faut demander le formulaire SE401Q (104 pour les stages en entreprise et 106 pour les stages en université) Pour tous les autres cas : Les étudiants qui engagent des frais de santé à l étranger peuvent être remboursés au retour auprès de la mutuelle qui leur tient lieu de caisse de sécurité sociale étudiante, sur présentations des justificatifs. Ils pourront se rapprocher de leur caisse d assurance maladie pour obtenir des feuilles de soins spécifiques à remettre au retour avec les justificatifs. Ces feuilles de soin sont également téléchargeable sur le site «www.ameli.fr» Attention, Quelque soit le pays, le remboursement se fait sur la base des tarifs de soins français et des écarts très importants peuvent exister avec les prix pratiqués dans certains pays, Il est donc fortement recommandé à l étudiant de souscrire une assurance maladie complémentaire spécifique, valable pour le pays et la durée du stage, auprès de l organisme de son choix (mutuelle étudiante, mutuelle des parents, compagnie privée ). Cette assurance complémentaire devra couvrir : Le surcoût lié aux tarifs plus élevés des prestations à l étranger Une prise en charge complète en cas de problème sanitaire urgent dont le rapatriement sanitaire Une assistance juridique dans le pays concerné Vous pouvez vous référer aux prestations proposées par votre mutuelle étudiante qui propose ce style de couverture sur leur site internet. Si l entreprise fait bénéficier l étudiant d une protection suffisante en vertu des dispositions du droit local, alors l étudiant peut choisir de bénéficier exclusivement de cette protection. Avant d effectuer un tel choix, il vérifiera l étendue des garanties proposées. Si cette protection existe, il est nécessaire de l indiquer à l article 9 de la convention de stage. Mademoiselle, Monsieur : Etudiant en :. Reconnait avoir pris connaissance des informations ci-dessus et fera le nécessaire pour s assurer la protection sociale la plus adaptée en fonction du pays dans lequel il/elle se rend, de l entreprise qui l intègre et de sa situation propre. Fait à le Signature de l étudiant