CAISTOR GRAMMAR SCHOOL
Work Experience Parental Initial Permission Form
I give consent for my son/daughter............................................................... in Tutor
Group........... to take part in the Work Experience Programme from Monday 15th
July to Friday 19th July 2013.
Please state below any health issues (e.g. colour blindness, asthma, eczema,
epilepsy, diabetes etc) which may affect choice of workplace. If there is any
additional information which you think would be relevant for us to know, please could
you mention this too. It is sometimes necessary for us to share such information with
the placement provider so that they can do everything reasonable to protect the
health, welfare and safety of the pupils.
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It is occasionally necessary for us (or the employer) to contact parents/carers during
the period of work experience. To ensure that our records are up to date, please
indicate below the name and daytime telephone number of the person who may be
contacted. Please inform me if any of the information changes between now and the
end of the school year.
NAME (PRINT)............................................................................................…………..
RELATIONSHIP TO PUPIL..........................................................................................
DAYTIME TELEPHONE NUMBER..............................................................................
AGE OF PUPIL AT START OF PLACEMENT (IN YEARS AND MONTHS) …………..
………………………………………………………………………………………………….
Please return this completed form to Mrs J E Robson (via form tutors) at the school
by Friday 21st December.
No pupil can be allocated a Work Experience placement unless the school is in
receipt of this permission sheet.
Signed...........................................
Please print name.............................................