HIGHGATE WOOD SCHOOL

APPLICATION FOR WORK EXPERIENCE

26th February – 2nd March 2018

Please complete this form using BLOCK CAPITALS and black ink.

Return to School by ASAP

PERSONAL DETAILS
Surname: / Tutor Group:
First Name: / Date of Birth:
Address: / Languages spoken:
Parent/carer name:
Post Code: / Parent/carer daytime tel:
Home Tel No:
Gender: / Email address:
GCSE SUBJECTS Please tick all the subjects you are studying this year
Maths PE Drama
English Food Technology Music
Double Science Graphics Languages

History Product Design RE

Geography Textiles Art
Are you studying a vocational course? If so, which one ……………………………………………………………………………
EXPERIENCE OF WORK/PART TIME JOB (If no experience state ‘none’)

HEALTH

Do you suffer from any illness or disability that might affect the work that you do? YES or NO (Please circle). If YES please give details.

WORK EXPERIENCE PREFERENCES

Please select a first, second and third choice from the list below.

You must choose at least one of the first three boxes shown

DO NOT TICK BOXES – WRITE 1 2 3

Business and administration Medical

In a private company e.g. a bank, solicitor’s Working in a doctor’s, dentist’s or hospital
office or local authority department reception area. Clerical duties only.

Working with children Sports and leisure

Assisting teachers/carers in a nursery, play Work in a leisure facility or sports centre
centre or primary school May involve evening work

Retail Technical

Sales and other duties in a shop. Might be Construction, gardening, warehouse duties,
a specialist shop, e.g. clothes, music electrical, mechanical engineering

Caring for the elderly/disabled Veterinary and animal care

In a day centre or residential home Assisting in a pet shop, animal refuge, city
farm or in a veterinary practice

Catering and hospitality Performing arts

Helping in a restaurant or café. Hotel Work. Working for a theatre, dance company,
theatre school. May involve evening work

Hair and beauty therapy

Assisting hairdresser/beauty therapist in a Media/ICT
salon Publisher, newspaper, record company, radio,
Graphics, ICT

Travel arrangements

Agreeing to travel anywhere in London increases the range of placements available to you but it will take longer to get to work and will cost more. The school cannot usually pay your fares.

Local area only Anywhere in London

Within Haringey (N4 N6 N8 N10 N11 N15 N17 N22) Accessible by tube/bus
Are there any postcodes which you are not allowed to access due to any reason/s………………………………………………………………………

ADDITIONAL INFORMATION

Use the space below to describe the type of work that you feel you can do best. If you have a career you want to follow in the future include this here.
Health & Social Care students (please give name and address of GP Surgery):
OWN PLACEMENTS

If you intend to arrange your own placement please tick this box
All own placements will be vetted for Health & Safety. Please note that placements which are found to be unsuitable for work experience will be rejected.
Full details about the placement will be required on the attached form which should be completed and returned by Monday 11th December 2017.

TUTOR COMMENTS

Needs support/
Cause for concern Satisfactory Good/Excellent
General academic ability
IT Skills (if known)
Fluency in English
Organisational Skills
Level of independence
Personal presentation
Attendance
Punctuality
Behaviour
General comments or concerns about the choices the student has made……………………………………………………..
Are the student’s choices suitable? YES NO (please circle)
…………………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………..
Tutor’s Signature…………………………………………………………….Date…………………………………………………..
DOES THE STUDENT HAVE A STATEMENT OF SPECIAL NEEDS? YES/NO
If yes, please give details
Name of SENCO :

Work Experience Contract

STUDENT CONTRACT
·  I agree to take part in the work experience scheme.
·  I agree to attend the place of work on the days and during the hours negotiated, except in the case of illness or for some other good reason.
·  I agree to observe all the safety regulations and to take all possible care to prevent an accident.
·  I agree to carry out instructions given to me by the employer or supervisor and to carry out any written rules or instruction to which my attention has been drawn.
·  I agree to treat as confidential anything which I find out about the employer’s business and not tell anyone without the employer’s permission.
·  I agree to dress appropriately and wear any uniform or clothes specified by my employer.
·  I agree to contact my employer and the school immediately if I cannot attend my work at any time.
·  I understand that the aim of the scheme is to provide me with experience of the world of work and not to provide experience of a specific type of job.
·  I am aware that a copy of the front page only of this application form will be sent to the employer.
·  I am aware that an offer of a work experience placement is dependant on my attendance, punctuality and behaviour.
Student’s Signature…………………………………………………………………Date……………………………………….

PARENT/CARER CONSENT

·  I agree to the student named above taking part in the school work experience scheme.
·  I understand that the aim of the scheme is to provide an introduction to the world of work and not to gain experience of a specific job.
·  To the best of my knowledge and belief the student does not suffer from any medical condition which would put them, or any other person, at risk.
·  I undertake that the student will observe the conditions set out above in the student agreement.
·  I understand that the student is not allowed to receive payment.
·  I understand that the school does not undertake to pay student’s transport costs.
·  I understand that my child will not be supervised during the lunch break if leaving the employer’s premises and that he/she may be given the opportunity to accompany staff on visits for work purposes.
·  I have read this form and am satisfied that the information given by the student is correct and that the student’s choices are suitable.
·  I agree to meet the deadline for submitting information should I wish to find a placement for my child.
·  I am aware that a copy of the front page only of this application form will be sent to the employer.
Parent / Carer’s Signature………………………………………………………..Date……………………………………….