STUDENT ARRANGED PLACEMENT FORM STUDENT DETAILS (BLOCK CAPITALS PLEASE) School Name: Student Name: Form: Student Signature: COMPANY DETAILS (BLOCK CAPITALS PLEASE OR ATTACH BUSINESS CARD/COMPLIMENTS SLIP) Company Name: Address: Postcode: Telephone: Fax: WWW: Email: COMPANY CONTACT DETAILS (BLOCK CAPITALS PLEASE) Contact Name: Contact Name: Telephone: Telephone: Email: JOB DETAILS (BLOCK CAPITALS PLEASE) Job Title: Dates: FROM: TO: Working Days: Working Hours: Tasks/Duties: As a representitive of the company, I agree to this student undertaking Work Experience placement with us in accordance wit hthe details above. I confirm that the company: (Please circle as appropriate) Is already involved in the B&E Together Work Experience programme YES NO Offers this place in addition to our existing/normal commitment YES NO (Students may already be allocated existing places, please don’t let them down.) Is not currently involved in the Work Experience programme, but is willing to provide placements in the future YES NO Has Employer Liability insurance (please give details below) YES NO Insurance company: ________________________ Policy number: ____________________ Expiry date: ______________________ Has a written Health and Safety policy (if 5 or more employees) YES NO Signature: __________________________________ Date: ___________________ Thank you for agreeing to take part in this Work Experience placement. B&E Together will send you confirmation of the allocated student in advance of the placement start date. Please could you tell us, how did the student find this placement? To ensure that we have the correct details of you and your company, please could you attach a compliments slip or business card to this form, thank you.
STUDENT ARRANGED PLACEMENT FORM STUDENT DETAILS (BLOCK CAPITALS PLEASE) School Name: Student Name: Form: Student Signature: COMPANY DETAILS (BLOCK CAPITALS PLEASE OR ATTACH BUSINESS CARD/COMPLIMENTS SLIP) Company Name: Address: Postcode: Telephone: Fax: WWW: Email: COMPANY CONTACT DETAILS (BLOCK CAPITALS PLEASE) Contact Name: Contact Name: Telephone: Telephone: Email: JOB DETAILS (BLOCK CAPITALS PLEASE) Job Title: Dates: FROM: TO: Working Days: Working Hours: Tasks/Duties: As a representitive of the company, I agree to this student undertaking Work Experience placement with us in accordance wit hthe details above. I confirm that the company: (Please circle as appropriate) Is already involved in the B&E Together Work Experience programme YES NO Offers this place in addition to our existing/normal commitment YES NO (Students may already be allocated existing places, please don’t let them down.) Is not currently involved in the Work Experience programme, but is willing to provide placements in the future YES NO Has Employer Liability insurance (please give details below) YES NO Insurance company: ________________________ Policy number: ____________________ Expiry date: ______________________ Has a written Health and Safety policy (if 5 or more employees) YES NO Signature: __________________________________ Date: ___________________ Thank you for agreeing to take part in this Work Experience placement. B&E Together will send you confirmation of the allocated student in advance of the placement start date. Please could you tell us, how did the student find this placement? To ensure that we have the correct details of you and your company, please could you attach a compliments slip or business card to this form, thank you.
Student-Arranged-Placement-Form.docx