Work Experience

Work Experience Application form
Name of Individual:*

First NameLast Name
Please complete this online form to make a request for Work Experience.

The Council will process information provided in this form for the purposes of implementing its Work Experience Procedure. The information will be shared with relevant departments within Council. All records relating to a young person who has participated in a work experience placement are retained for 6 years after they reach 18. All records relating to all others who have participated in a work experience placement will be kept for 6 years from the date the work experience finishes. This is in line with our Retention and Disposal Schedule.
Our work experience opportunities are open to individuals who meet any of the following criteria:
- Reside within our borough, and/or
- Attend an educational establishment (school or college) located within our borough and have a requirement to complete work experience, or
- Attend University and have a requirement to complete work experience, or
- Are affiliated with an employability support organisation and have a requirement to complete work experience
Priority will be given to applicants who live, study, or are supported within our borough.
Criteria*

Please tick this box to confirm that at least one of the above criteria applies to you.
Opportunity*
If this opportunity is available at more than one location, please indicate your preferred location(s) below

ArmaghBanbridgeCraigavon
School/College/Organisation Details
Name of School/College/Organisation:*
Address*

Street Address

Street Address Line 2

CityState / Province

Post Code
Contact Person:*
Telephone number:*
E-mail:*
example@example.com
Work Experience individual Details
Name of individual:*

First NameLast Name
Address*

Street Address

Street Address Line 2

Town/CityState / Province

Postal Code
DOB*

MonthDayYear
Date
Dates of placement requested from:*

DayMonthYear
Date
Where applicable, please indicate which days of the week you are available to undertake work experience.(Tick all that apply)

MondayTuesdayWednesdayThursdayFriday
If your availability varies or depends on specific dates, please provide further details below:
Qualifications achieved to date, where relevant e.g. GCSEs- please list subjects:*
Qualifications currently being studied (if any)
If unrelated to study provide details
Work Experience Outcomes
Please outline what you (the individual) wish to achieve as a result of completing the work experience placement:*
Medical information/Health Declaration
Does the person seeking work experience/placement have a medical condition that Armagh City, Banbridge and Craigavon Borough Council should be aware of? (Please note if the answer is No, add N/A in the comments)*

YesNo
If yes, please provide details of any assistance or support he or she may require whilst on work experience/placement*
Please note if the answer is No, add N/A in the comments.
Does the person seeking work experience/placement have a disability that Armagh City, Banbridge and Craigavon Borough Council should be aware of? (This includes individuals with physical, hidden, learning, sensory, and mental health disabilities, as well as those who are neurodiverse) (Please note if the answer is No, add N/A in the comments)*

YesNo
If yes, please state nature of disability*
Please note if the answer is No, add N/A in the comments.
Please provide details any assistance/ reasonable adjustments he or she may require whilst on work experience/placement.*
Please note if the answer is No, add N/A in the comments.
Does the person seeking work experience/placement suffer from any allergies? (For example allergies to food, drink, medication, gloves, chemicals etc.) (Please note if the answer is No, add N/A in the comments)*

YesNo
If yes, please provide details of the type of allergy and the medication used to control the Allergy*
Please note if the answer is No, add N/A in the comments.
Thank you for your interest!

We process your personal data in accordance with our legal obligations under the Data Protection Act 2018 (DPA) and the UK General Data Protection Regulation (UK GDPR). More Info
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Work Experience Application form

School/College/Organisation Details

Work Experience individual Details

Work Experience Outcomes

Medical information/Health Declaration