Student and Parent Work Experience Agreement Form

Name of Student

Name of Parent/Guardian

Employer Details - Company Name

Name of Contact Person

Their role within the Company

Contact email

Contact phone number

Company Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Description of Work Experience role

For an organisation to accept a student on work experience they must have Employer's Liability Insurance that includes under 18 year olds. The school will check this with the employer.

Hours of Work

Student Signature

Clear Signature

As the above named student, I agree to attend the work experience placement and agree that a) any information obtained about the employer's business will be held in strict confidence and will not be disclosed without the Employer's permission b) I will adhere to all safety, security and any other requirements as identified by the Employer's representatives and/or by displayed instructions.

Parent/Guardian signature

Clear Signature

As the parent/guardian of the above named student, I confirm that I agree to the student attending this placement and confirm that they do not suffer from any medical or health condition (eg. allergies/asthma) that may affect the placement. If they DO suffer from a medical or health condition, I confirm that this will be shared with the employer as deemed appropriate.