ACTIVITY AGREEMENT
PLACEMENT GUIDANCE & CHECKLIST
Please complete this form as fully as possible and return to the Activity Agreements Coordinator at the earliest
opportunity if any work based activity or work placement forms part of the Activity Agreement.
Work Placements
When a young person identifies a potential career area or employer they would like to consider a placement with ,
the advisor must contact the employer to discuss what Activity Agreement s are and what the young person is aiming
to achieve.
Initially employers and the Young Person must be advised that a successful offer of a placement will only be made
after authorisation from the Highland Council. This is to allow for checking of insurance documents and any site visit
to be undertaken (employers should be advised that a site visit may be required and the purpose of such a visit.)
An employer may wish the Young Person to submit a letter of application, phone them direct or attend an interview
prior to agreeing a placement. If this is requested it may be necessary for advisors to work with the young person to
support them in doing this.
Notes:
 Site visits: each role within a company is given a risk level to allow identification of the frequency of site
visits required to the premises (e.g. low risk role - every three years, medium risk role – every two years,
high risk role – every year)
 Insurances: Highland Council must hold details confirming expiry dates for employers liability and public
liability if applicable.
 Highland Council has a responsibility for the Young Persons wellbeing and must ensure that placements
are suitable and safe
Disability, Health or Medical Conditions
This information is required about the Young Person to allow their individual needs to be discussed with an employer
or provider. This will assist in adapting conditions such as start and finish times, how inductions are carried out,
suitable tasks etc.
Examples of the information we require may include:
 Specific Learning Difficulties (e.g. Dyslexia, Dyspraxia, AD(H)D)
 Unseen Disabilities (e.g. Diabetes, Epilepsy, ME, Skin Conditions, Colour Blindness, Insomnia, Depression)
 Physical impairment or mobility issues (e.g. using arms/legs, wheelchair/crutches, sight impairment,
hearing impairment)
 Autistic Spectrum Disorders (e.g. Aspergers Syndrome, Tourettes Syndrome)
Where a Young person has indicated a disability, health or medical condition further details must be provided on
how this affects them to ensure the placement is suitable for their needs (e.g. with Aspergers Syndrome clear
instructions must always be given for tasks and confirmation obtained that the Young Person understands what is
being asked of them)
The above lists are not exhaustive and any relevant information provided by the young person must be included.
PPE (Personal Protective Equipment)
In general there will be some PPE that employers will provide as standard, this may include eye or ear protection,
hard hats, “hi vis” clothing. However some employers will request the Young Person provides their own PPE:
This may include boiler suits, safety boots, gloves, waterproofs.
If PPE is required confirm with the employer what they will supply and what the Young Person must supply.
Note this on the form. Please also note the sizes required (e.g. safety boots - size 10, boiler suit - size 40”,
gloves – med, waterproof trousers – size XXL). To allow us to order PPE sizes must be included for all items.
July ’11 revision Paul Macmillan/Matthew MacIver/Linda King
PLACEMENT CHECKLIST
Name of Young Person:
D.O.B:
Does the Young Person have any Disability, Health or Medical Conditions?
Yes/No (delete as appropriate)
If yes please give details (including details of any medication required)
Has the employer/placement been advised of the above?
Yes/No (delete as appropriate)
Will the Young Person be accompanied during their work placement/work based activity
(e.g. job coach/SDS advisor etc)?
Yes/No (delete as appropriate)
If yes please provide details: (e.g. job coach support for entire placement, phased our support etc)
Name and address of
Employer/Provider:
Contact Name:
Telephone No’s: (including mobile, if
provided)
Role Young Person will be carrying
out: (e.g. Joiner, Hairdresser)
Days of Placement: (e.g. every Monday,
2 days per week)
Duration of placement: (e.g. 1 week, 6
weeks, 3 months, ongoing)
Is PPE (Personal Protective Equipment e.g. safety boots/boiler suit) required?
Yes/No (delete as appropriate)
PPE supplied by Employer/Provider:
PPE Not supplied: (please note sizes required of each relevant item)
July ’11 revision Paul Macmillan/Matthew MacIver/Linda King