Career Services

Curricular Internship Project Form 1 di 3

(Ref. Agreement n. PO/ / POS/25 stipulated on date / / , by the University)

Curricular Internship Project Form (by the Employer)

Employer Details Host Company: Business Name: Internship Location: Industry/Production area: VAT Number/Tax Code: Website: Legal Representative (First and Last Name): Phone/Fax: Email Address:

Intern’s details Last Name: Name: Place and Date of Birth: Mailing Address: Home Address (if different from mailing address): Tax Code: Department and Degree Program Name: Enrollment Year: 2018/2019 2017/2018 2016/2017 2015/2016 2014/2015 2013/2014 Other: Year of Study: (1°, 2°, 3° Bachelor, 1° e 2° Master, 1°, 2°, 3°, 4°, 5° Single Cycle): Student Identification Number: Email: Phone/Mobile:

Internship details Internship Location: Timetable to access to company premises: - From To

Career Services

Curricular Internship Project Form 2 di 3

Length and duration of the internship: From / / To / / (start and end date) For a total of months (maximum 6): Total hours of the internship: Attainment of University Credits (UC): Yes No If Yes, number of credits required by study plan: 4 6 8 12

Luiss Supervisor: Raffaella De Felice

Insurance policies: • Civil liability coverage with Unipolsai Company, n. 150054304• Accident insurance with UNIPOLSAI n. 150055537/2

Facilitation (if any): Expenses refund Yes No if yes, specify Luncheon voucher Yes No if yes, specify Other Yes No if yes, specify

Details of Employer Supervisor Last Name: Name: Job Title: Tax Code: Email Address: Phone/Mobile:

Learning objectives and internship description

Competencies to acquire

Libera Università Internazionale degli Studi Sociali Guido Carli

Curricular Internship Project Form To be completed in Word and sent at least 15 working days before the start of the internship to the e-email tirocinicurriculari@luiss.it, specifying in the Company Name – Student number_Last Name (eg: PW – 113456_Rossi). 3 di 3

The intern’s duties • Follow the instructions of the supervisor and refer to them for any organizational or other need;• Respect the confidentiality requirements about production process, products or other information

about the Employer of which he has knowledge, both during and after the training period;• Comply with Employer regulations and rules on hygiene and safety.

Tools used to identify the interns Application on the Employer website Application on the Luiss Career Center

Career Day Luiss CV Book Luiss

Other Specify

Intern’s signature

Stamp and signature of the Host Company Stamp and signature of Luiss Guido Carli General Manager Giovanni Lo Storto

Rome,