Work Experience Application Form

Transcription

1 Work Experience Application Form NAME: Start Date: End Date: Return to: Construction Ambassador Willmott Dixon Partnerships Michael Pearson Swanage Court, Dodds Close Bradmarsh Business Park Rotherham S60 1BX IT IS THE RESPONSIBILITY OF THE WORK EXPERIENCE INITIATIVE/STUDENT TO PROVIDE & ENSURE THEY WEAR THE APPROPRIATE WORK WEAR INCLUDING SAFETY FOOTWEAR. WILLMOTT DIXON PARTNERSHIP WILL PROVIDE HI VIZ WEAR i.e. VEST/JACKET/GLOVES/GOGGLES/HARD HAT WHILST ON SITE.

2 Personal Details Surname First Name(s) Date of Birth Home Address Parent/Guardian/Next of Kin Home Telephone number Mobile Telephone number Ethnicity School/or Work Experience Initiative Details School/Initiative Schoo/Inititaive telephone number Name of your work experience co-ordinator / form tutor Dates of your work experience Subjects you are currently studying if applicable It is your own responsibility to get to and from your work placement please confirm by signing the adjoining box that you can get to work by your own travel arrangements.

3 Supporting Information Please indicate why you are interested in spending your work experience with Willmott Dixon Partnerships What are your expectations of the placement? Please list any outside activities, interests and any other information you feel is relevant to your application

4 School/College/Initiative Reference School/Initiative Contact name Telephone number Please state why you support the student s/this persons application for work experience Your Signature Date

5 NOTES TO PARENTS/GUARDIANS/CARERS Arrangements are being made for your daughter/son to take part in a structured one / two-week placement within Willmott Dixon Partnerships. This school activity has been organised in accordance with The Education (Work Experience) Act of All companies and organisations offering work experience have signed a letter of understanding covering the following points: The student will be given meaningful work, planned by a responsible person. They will be given appropriate instructions before and during operation of any machinery or equipment. Students will not receive payment for this work in accordance with the terms of The Education (Work Experience) Act. The employer has arranged for insurance cover against accident or injury caused to the students by the negligence or the loss, damage, or injury caused by the student while acting as a servant of the organisation, to the employer s property, other employees or a third party. A Young Persons Risk Assessment will be undertaken by the employer and a Health and Safety check will also be completed. She/he will obey all safety, security and other instructions given by the employer. You will be asked to ensure that your son/daughter keeps to this agreement and to confirm that he/she is not suffering from any complaint, which could create a hazard either to your son/daughter or those working with him/her. Please tick one of the two boxes below: o o I confirm that my son/daughter does NOT suffer from any medical condition, which could result in a risk to his/her health or the safety of any person (if you are unsure, please talk to the Work Experience Co-ordinator at your son/daughters school). I confirm that my son/daughter DOES suffer from a medical condition which their work experience employer needs to know about. If yes please give details and/or a contact telephone number for further discussion: As parents / guardian / carer of (please write your son / daughters name) At (Please write schools name) School, I confirm that I have read and understood this form and that I agree to my son/daughter taking part in work experience. Signed Date

6 (Parent / Guardian / Carer Signature) FOR USE BY WILLMOTT DIXON ONLY This part of the form is to be signed by both the branch Construction Ambassador then signed as authorised by the branch General Manager to show agreement of the work experience student being placed at the branch before work placement can commence. The General Manager must agree the training work experience plan with the Construction Ambassador before authorising the work experience. Signatures Construction Ambassador Name Signature Date General Manager Name Signature Date