Placements
Type of Work Experience / Placement
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--None--
Paid Work Experience
Sandwich Year
Voluntary Work Experience
School
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--None--
Architecture
Biological and Medical Sciences (BMS)
Built Environment
Engineering, Computing and Mathematics
Psychology, Social Work and Public Health (PSP)
Sport, Nutrition and Allied Health Professions (SNAHP)
Subject Area
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--None--
Course
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--None--
Module Code
Placement Details
Role Title
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Start Date
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Finish Date
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Currencies
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£ - GBP
$ - USD
€ - EUR
Other
Salary Frequency
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--None--
Hourly
Daily
Weekly
Monthly
Annually
Salary (and benefits)
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Hours Per Week
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Your Responsibilities
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Organisation
Organisation Name
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Main Switchboard Number
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Placement Address
Street
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City
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County
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Country
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Post Code
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Company Contact
First Name
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Last Name
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Telephone
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Email
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Job Title
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Supervisor / Line Manager
First Name (If different)
Last Name (If different)
Phone (If different)
Email Address (If different)
Job Title (If different)
Fitness to Practice
Safeguarding
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--None--
Yes
No
N/A
Safeguarding Cert Number
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Safeguarding Date
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DBS
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--None--
Yes
No
N/A
DBS Number
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DBS Date
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First Aid
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--None--
Yes
No
N/A
First Aid Cert Number
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First Aid Date
*
Other Requirements
Your Developmental SMART Targets
SMART Target 1
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SMART Target 2
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SMART Target 3
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For BSc students only
Are you aware of the aims and objectives of the Work Experience module?
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--None--
Yes
No
Are you aware of the Association for Nutrition’s (AfN) core competencies and standards of ethics, conduct and performance?
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--None--
Yes
No
Risk Assessment
Have you attended all mandatory health & safety/ academic assignment briefing sessions that take place before the start of the placement/internship/WB Learning?
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--None--
Yes
To follow
Have you received health & safety information from your placement employer?
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--None--
Yes
No
To Follow
Have you reviewed the Module Guide (including the deadlines for each assignment) and the Placement Guide along with emergency contact details on Moodle?
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--None--
Yes
To follow
As far as you are aware, how would you rate your travel and transportation risks?
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--None--
LOW: No significant Travel (reasonable daily commute)
MEDIUM: Long daily commute / regular driving / night travel (As part of expected duties or anticipated work pattern)
HIGH: Demanding travelling / driving unfamiliar vehicles / driving others ( As part of duties)
As far as you are aware, how would you rate the location/ regional risks?
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--None--
LOW: UK with no significant local risks
MEDIUM: Overseas (non-UK) in low risk countries (as per the Foreign & Commonwealth Office)
HIGH: Overseas (non-UK) in high risk country with significant risk of civil disorder/ crime/ war zone areas
As far as you are aware, how would you rate your working environment?
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--None--
LOW: Office/ business environment
MEDIUM: Working in industrial / workshop / building site / laboratory / hospital environment with in-house training is provided.
HIGH: Working with hazards that have the potential to cause permanent injury or fatalities such as operating heavy machinery, handling of large volumes of dangerous compounds or pathogens above biohazard level 2
How much of your experience is on-site/ in the office?
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--None--
Entirely virtual
Hybrid- partly on site/ in the office and partly working from home
Entirely on-site/ in the office
As far as you are aware, how would you rate the general health and safety risks associated with work place activities?
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--None--
LOW: No significant health risks
MEDIUM: Some precautionary measures are required and in place (such as optional inoculations / medical travel kits, protective clothing / equipment).
HIGH: Mandatory and specific health protection (such as working in very hot, cold or strenuous conditions or compulsory inoculations)
How would you rate risks associated with your personal circumstances?
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--None--
LOW: You have no personal factors that may cause episodes of illness and you understand the role requirements
MEDIUM: You have personal factors that may require specific adjustment or support during work
HIGH: You have personal factors (i.e. health, disability, linguistic or cultural) which may increase the risk of illness or accident
As far as you are aware, how would you rate the insurance risks?
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--None--
LOW: UK and covered by the employer's public liability insurance
MEDIUM: Overseas and covered by the employer's liability insurance
HIGH: Overseas and not covered by the employer's liability insurance
I agree to inform the placement office if I am absent from work for 7 consecutive working days or more (excluding paid annual leave)
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If, following commencement, I have any concerns regarding any aspect of my experience, I will contact my Tutor or the office
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I will remember to re-enrol for my placement/internship/WB learning via my student record page.
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I will contact the module leader or faculty employability office if there are any changes during my placement/internship/WB learning(i.e. address, line manager/ mentor)
*