Work Experience Application Form (Page 2 of 6) in pdf

2. Work Experience Application Form: Details of Work Experience Sought

Pg 2 of 6

Work Experience Dates

Standard work experience (shadowing) opportunities come in 5 day blocks, Monday to Friday, with dates

confirmed in advance of the placement starting. Please list below your 1

preferred work experience date.

If you wish you can add 2

& 3

preference dates too if you have some flexibility.

Start date DD/MM/YY

End date DD/MM/YY

Start date DD/MM/YY

End date DD/MM/YY

Start date DD/MM/YY

End date DD/MM/YY

Age restrictions

If you are aged 14 and 16 we are only able to offer non-clinical/medical placements working in an

office/administration environment.

What age will you be on the date you intend to start your work experience placement?

Work Experience Sought

It is helpful in placing you if you can list 2 or 3 suitable alternatives. Whilst we cannot guarantee a specific

placement we will always try and place you in your preferred area.

When listing your choice(s) remember the age restrictions on Page 1 & also that clinical opportunities are often

limited and cannot be guaranteed – we would advise also listing an office/admin. based alternative.

Area you want work experience: List 2 or 3 preferences only, it will be useful to check the Trust website

first:

D ue to demand, the limited numbers of available clinical placements are often

reserved for those already undertaking studies in related areas.

If you have already agreed placement arrangements with someone, please include their full name and

contact details here so we know to go directly to them.

Supporting Information: Supporting information may include hobbies, interests, volunteering you’ve done

or other activities relevant to the application – you should also include any academic areas of study

relevant to the placement request. This is your opportunity to promote yourself as the best candidate to

get the placement.

(Use a separate sheet if needed & send in, include your name in any additional document’s subject title).

Goals and Objectives: Describe your personal objectives which you hope to achieve from this placement

Work Experience Application Form Page 2