University Code of Practice
Placement Learning (QH:K9)
Annexe 5a
Student Placement Conduct Agreement Template for Tier 4 Students
Placement Conduct Agreement made on [insert date] between
1.
The University of Hull of [insert name of Department/School], Cottingham Road, Hull
HU6 7RX (the University) and
2.
[insert name] of [insert address] (the Student)
This agreement outlines the expectations of the University and the responsibilities of the Student in
respect of the provision of a placement experience by [insert name of placement provider] (the
Placement Provider) in accordance with the agreement set out in the Appendix [the agreement between
the University and the Placement Provider]
Note: where a term is not defined in this agreement, the definition set out in the Appendix will apply.
The Student, as a representative of the University will behave in a professional and responsible manner
and in accordance with University Regulations. The Student will attend any pre-placement induction or
health and safety training offered by the Placement Provider or the University.
If the Student has to be withdrawn from the Placement for disciplinary reasons, action may be taken in
accordance with the University’s Student Disciplinary Regulations
(https://hydra.hull.ac.uk/assets/hull:4693/content) and, if applicable, the University Code of Practice:
Professional Unsuitability and Professional Misconduct
(http://www2.hull.ac.uk/administration/docs/F17%20%20Professional%20Misconduct%20Unsuitability%20-%20Version%202%2004%20%20July%2014.docx)
The University expects the Student to:
• abide by all rules regarding health and safety requirements, and other practices and procedures of the
Placement Provider;
• give due consideration to all information provided by the University Placement Coordinator and the
Placement Contact;
• carry out the work or study programme specified by the Placement Provider under the supervision of
the specified supervisor(s);
• assess their learning experience during and after the placement and provide feedback to the
University as required;
• inform the Placement Provider of any health concerns or disability that may require reasonable
adjustments to be made;
• report any concerns about health and safety at their Placement to their Placement Provider;
• report to the University Placement Coordinator any incidents in which they are involved and any
health and safety concerns that are not addressed by their Placement Provider;
• notify the University Placement Coordinator if any issues occur whilst on Placement that jeopardise
the success of the Placement;
Placement Learning
Learning Enhancement and Academic Practice
Version 1 00 – Oct 14
QH:K9
Annexe 5a:1
• notify the Placement Contact and the University Placement Coordinator of any change in personal
circumstances that may be relevant to the Placement; e.g. contact details, criminal conviction,
sickness absence, early completion of the placement etc.
The Student agrees to:
• attend the health and safety briefing session as part of their placement preparation and familiarise
themselves with all information provided;
• inform the University Placement Coordinator of any personal factors (e.g. health, disability, linguistic
or cultural) that may affect the level of risk or may require reasonable adjustments to be made whilst
on placement;
• report promptly to the University Placement Coordinator, if they do not wish to continue with the
placement. Note: it is expected that the University Placement Coordinator will inform the University
Visa Support team who will take appropriate action with respect to the student’s Tier 4 status with the
Home Office;
• report, within five working days of being notified, a permanent change of work location during the
placement;
• confirm absence (for example agreed holiday leave) with the University Placement Coordinator
contact;
• attend agreed meetings with the University Placement Coordinator;
• allow personal data which is reasonably believed to be relevant to the Placement to be shared by the
University and the Placement Provider.
I have read and agree to the above.
Student Name:
Signature:
Signed by an authorised representative for and on behalf of the University of Hull
Signed:
Print Name:
Once completed and signed the University Placement Coordinator must retain the original copy,
send a copy to the Placement Contact and a copy to the University Visa Support Team. A
member of the University Visa Support Team will scan the agreement and attach it to the
student’s file.
This document is available in alternative formats from Learning
Enhancement and Academic Practice
Placement Learning
Learning Enhancement and Academic Practice
Version 1 00 – Oct 14
QH:K9
Annexe 5a:2