Transcription of APPLICATION TO CONVERT A FOREIGN VACCINATION …
APPLICATION TO CONVERT A FOREIGN VACCINATION CERTIFICATE INTO A FRENCH COVID CERTIFICATE I, the undersigned, SURNAME:.. First name(s): .. Address (in country of residence abroad): .. Country in which the vaccine was administered (if other than the country of residence):.. Date of arrival in France: .. Date of departure from France: .. E-mail address: .. Te l e p h o n e n u m b e r ( p l e a s e i n c l u d e c o u n t r y / a r e a code): .. Hereby request that my COVID-19 VACCINATION certificate, issued by the competent authorities in my country of residence, be converted into a French COVID certificate. I certify that the vaccine I received abroad is recognized by the European Medicines Agency (EMA). To that end, I hereby attach with this dated and signed form: A copy of my photo ID (valid passport) A copy of the VACCINATION certificate issued in my name by the competent authorities in my country of residence, clearly stating the type of vaccine used My travel ticket Done at.
21-2793-demande de conversion de certificat de vaccination_ang created date: 20210809131942z ...
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