Swanmore College - Work experience Form 15-19th July 2024
Thank you for supporting a young person from Swanmore College by offering a work experience placement for them.
The following form is an easy way for us the collect and collate the information required to support our young people. We are trialing this as an alternative to our paper forms.
If you have any questions regarding completing this form please do not hesitate to contact Mrs Illsley, Careers leader at Swanmore College via careers-help@swanmore-sec.hants.sch.uk
Please read the attached Letter of Understanding which outlines your responsibility as an employer undertaking work experience with us.  Letter of understanding
If you are happy with the attached document then please complete the form to the best of your ability for the young person that has requested work experience with you.
If you are taking more than once person then please complete one form and add additional students names where asked. 


Sign in to Google to save your progress. Learn more
Email *
Surname of pupil *
First name of pupil *
Date of birth
MM
/
DD
/
YYYY
Tutor Group *
Any additional pupils you are also taking from Swanmore at the same time
Company/organisation name *
Nature of business *
Number of employees *
Main contact person *
Position in company/job title *
Company address *
Post code of company *
Contact number *
Email contact *
Employers Liability insurance details (include Insurer, Policy number and Expiry Date) *
Placement you are offering (job title) *
Brief job description (what they would be doing during the week) *
Any special requirements
No of working days *
Required
Dates if different to 15-19th July
Working times and breaks  *
Are you able to offer a placement to another student? *
Required
Would you be willing to support Swanmore School with any other Careers activities *
Is there someone in charge of Health & Safety?
Please name them ....
 *
Do you have a written Health and Safety Policy? *
Please confirm the pupil will receive an induction in Health & Safety on Day 1 (or prior to starting) *
How will this be covered? *
Required
Will you make arrangements to give the student appropriate information, instruction and supervision inc Health & Safety throughout the placement? *
How? *
Have risk assessments been carried out for your working environment? *
Do you have a risk assessment for young people (under 18)? *
Have all risks been reduced to their lowest level through a safe system of work? *
Does the placement require the use of PPE and has it been agreed who will provide? e.g. Safety boots *
Do you have systems in place to deal with accidents and to administer first aid? *
Do you have current fire risk assessment for the premises? *
Are appropriate Health & Safety signs e.g. Fire exit signs) displayed in the work place? *
Do you have toilets and washing facilities? *
Are you are aware of Safeguarding  relative to young people and how to report any issues if the need arises? *

I confirm that:

- to the best of my knowledge and belief, the information given above is correct. 

 - I have read the attached Letter of Understanding and that all the points are acceptable to me.

  -  I confirm that the Job Description is correct.

As representative of the employer I agree with the student named above working on our premises, and to abide by all legislation relating to Equal Opportunities, Health and Safety and Child Protection. I will arrange for my Employer’s Liability Insurance to provide cover against accident and injury caused to the student by negligence of the employer or another employee and will accept or insure myself against liability for loss, damage or injury caused by the student in the same way as for other paid employees. My company/organisation has prepared a Risk Assessment (if applicable) and a safe system of work which covers all the tasks we expect this student to undertake.                  

Please record your name and date below to accept the above.                                                               

 *
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Swanmore College. Report Abuse
Google Forms