VOICE AND DANCE / IRISH MUSIC AND DANCE PLACEMENT DETAILS

Note:

Please complete entire form ( typed only) and checklist ( on the last page of this form) before submission :

Student details:

Name:______I.D. Number:______Course: ______

Address:______Telephone number: ______

Placement details:

Jan-Summer: ______Split Placement: ______

Jan-September: ______Rate of pay: ______

May-Jan: ______

Start date: ______Completion date: ______

Student signature: ______Date: ______

Garda vetting requirement:

-Does your employer(s) require Garda vetting? Yes:☐ No:☐

-If yes, does the organisation intend to undertake its own Garda vetting on your behalf? Yes:☐ No:☐

-Or will the organisation accept results of the UL Garda Vetting Process? Yes:☐ No:☐

Summary of Placement:

(Please note that only two placements appear on your transcript. Please list in order of preference.)

Placement 1:No. of hours (spread over 5 days):

Placement 2:No. of hours (spread over 5 days):

Placement 3:No. of hours (spread over 5 days):

N.B. Verification of Placement

You must attach the following when you submit this form to the Cooperative Education Careers Division: (please ensure you tick the checklist included on the final page of this form)

A letterfor each employer, on company letterhead, signed by that employer, outlining your hours and duties, specifying your commencement and termination dates of employment

Failure to supply all the information requested will result in your placement not being recorded on your transcript and possible failure of Cooperative Education. At the end of your placement, an Evaluation Form will be issued to your employer to assess your performance. This form is returned to the college by the employer and is used in assessing your overall grade for Cooperative Education.

PLACEMENT 1

Placement Details:please type

Name of employer: ______

Address: ______

Telephone: ______Email: ______

Supervisor/Contact person: ______

Placement dates: ______to ______Number of hours (over 5 days):

Description of activities: please type

Please give a detailed description of activities:

______

______

______

______

______

______

______

Employer letter to be attached (including dates, duties and hours per week)

PLACEMENT 2

Placement Details:please type

Name of employer: ______

Address: ______

Telephone: ______Email: ______

Supervisor/Contact person: ______

Placement dates: ______to ______Number of hours (over 5 days):

Description of activities: please type

Please give a detailed description of activities:

______

______

______

______

______

______

______

Employer letter to be attached (including dates, duties and hours per week)

PLACEMENT 3

Placement Details:please type

Name of employer: ______

Address: ______

Telephone: ______Email: ______

Supervisor/Contact person: ______

Placement dates: ______to ______Number of hours (over 5 days):

Description of activities: please type

Please give a detailed description of activities:

______

______

______

______

______

______

______

Employer letter to be attached (including dates, duties and hours per week)
CHECKLIST FOR OWN PLACEMENT DOCUMENTATION:

Student name, I.D., course, address, telephone Yes ☐

Placement datesYes ☐

Indication if the organisation/ employer requires Garda vetting Yes ☐

Employer nameYes ☐

Employer addressYes ☐

Employer telephoneYes ☐

Employer emailYes ☐

Contact person / supervisor within organisation of employerYes ☐

Description of duties/ role while working with employer Yes ☐

Letter from each employer: on letter-headed paper / signed by employer Yes ☐

Number of hours of work done per week of placement with each employer Yes ☐

QF047Version 1