Placements
HSS Type
*
--None--
Japanese Studies Year Abroad
Work Placement
Student Details
Student No.
Student First Name
Student Last Name
Placement Details
Role Title
Start Date
Finish Date
Benefits
--None--
Expenses
Accommodation
Food
Other
Other Benefits
Proposed Placement Tasks
Format of Placement
--None--
Wholly remote
Hybrid
Wholly in-person
Hours Per Week
Organisation Details
Organisation Name
Location
--None--
UK
Overseas
Main Switchboard Number
Placement Address
Street
City
County
Country
Post Code
Placement Contact
First Name
Last Name
Job title
Telephone
Email Address
Risk Assessment:
Risk assessment examples/guidance
You will need to refer to the risk assessment examples/guidance to answer the questions below. The guidance will help you assess levels of risk associated with your placement, understand if mitigation is needed, and understand what kind of actions you can take to manage those risks.
Have you reviewed the Module Guide (including the deadlines for each assignment) and the Placement Guide along with emergency contact details on Moodle?
--None--
Yes
To follow
As far as you are aware, how would you rate your travel and transportation risks?
--None--
LOW:No significant Travel
MEDIUM: Long daily commute / regular driving / night travel
HIGH: Demanding travelling / driving unfamiliar vehicles / driving others
Travel/transportation factors what risk(s) have you identified and what will you do to mitigate these? If nothing is required, please put N/A
As far as you are aware, how would you rate your working environment?
--None--
LOW: Office/ business environment
MEDIUM: Industrial/ workshop/ building site/ kitchen environment with in- house training provided
HIGH: Working with hazards that have the potential to cause permanent injury or fatalities such as operating heavy machinery
Work factors what risk(s) have you identified and what will you do to mitigate these? If nothing is required, please put N/A
As far as you are aware, how would you rate the general health and safety risks associated with work place activities?
--None--
LOW: No significant health risks
MEDIUM: Some precautionary measures (such as optional inoculations/ medical travel kits
HIGH: Mandatory and specific health protection (such as working in very hot, cold or strenuous conditions or compulsory inoculations)
General/environmental health factors what risk(s) have you identified and what will you do to mitigate these? If nothing is required, please put N/A
How would you rate risks associated with your personal circumstances?
--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
Personal circumstances what risk(s) have you identified and what will you do to mitigate these? If nothing is required, please put N/A
As far as you are aware, how would you rate the location/ regional risks?
--None--
LOW: UK with no significant local risks
MEDIUM: Overseas placements in low risk countries (as per the Foreign & Commonwealth Office)
HIGH: Significant risk of civil disorder/ crime/ war zone areas
Location factors what risk(s) have you identified and what will you do to mitigate these? If nothing is required, please put N/A
Additional details
I am aware of the visa requirements of my host country and understand I am responsible to adhering to the guidelines associated with my travel and study/work in that location. Refer to
https//www.gov.uk/foreign-travel-advice
Pre-departure form completed
--None--
Yes
To Follow
Please use this box to add any further detail or to make us aware of any other important information
The information I have provided to Oxford Brookes by completing information is to the best of my knowledge accurate and truthful. I understand that failure to declare any important information about my current physical or mental health that may impede my ability to work or study abroad and also impede the University's ability to provide necessary advice and support. I also understand that the University's insurers do not cover prior existing medical conditions.
I agree to inform the placement office if I am absent from work for 7 consecutive working days or more (excluding paid annual leave)
I understand that my Placement can not start until I have approval from my module leader, a fully signed Work Placement Agreement (if undertaking a work placement) a and have completed a pre-departure form (if travelling overseas). I am aware that the Partnerships and Placements team will advise me if and when I am cleared to go on placement.
If, following commencement, I have any concerns regarding any aspect of my placement, I will contact my Placement Tutor or the Placement office
I will log a Placement Update via the portal if there are any changes during my placement (i.e. placement address, line manager/ mentor)