Work Experience Placement

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Work Experience Application Form
Work experience is a period of time spent in a workplace for those who are



Still in full time education
Looking for a career change
Wish to get back into employment.
The time frame of placements can be very varied and the period of stay could be as little as
one day per week. Where ever possible the Entry to employment team will help to source you
a suitable and valuable work experience placement that will help you to achieve your goals. As
part of our commitment to creating quality placements we will ensure that both parties get the
most out of the placement. The Council conduct risk assessments for all of our work
experience candidates and are covered by the Council's liability insurance.
> Tell us who you are and how to get in touch with you
Name
Address
Date Of Birth
Daytime Telephone Number
E-mail Address
College/University
Course
> Type Of Work Experience Placement
Please detail the type of placement you’d like apply for. To apply for both a Specific Date/Fixed
Term Placement and an Ongoing Placement please complete both sections
Specific Date/Fixed Term Placement
Ongoing Placement
Start Date
Days/Times
Available
Number Of Weeks
Number Of Available
Hours Per Week
> Please detail any specific areas/departments of Coventry City Council you’re
interested in gaining experience.
> Tell us about any previous voluntary experience or any previous employment you
have?
> Do you have specialist skills, interests or hobbies that you would like to use when
conducting a work placement for Coventry City Council?
> Are there any particular skills you would like to develop when conducting a work
placement for Coventry City Council?
> Additional Information – please include any other information that you consider
relevant to your application.
> Coventry City Council welcomes applicants with all range of abilities for the skills
they bring. We aim to create a positive environment that enables all individuals to
realise their full potential. So we can consider any appropriate adjustments and better
support you in your role, please give details below of any disabilities or health
conditions.
> Important information
> Information about visas If you are from the European Union, you are free to conduct a
work placement in the UK. For those from outside the EU, you will need to check that your visa allows
you to volunteer. We advise that you contact the UK Borders and Immigration Agency to find out.
Coventry City Council is not able to sponsor volunteer visas.
>References May be requested to assess suitability before starting a work experience
placement.
> Disclosure and Barring Service Before conducting work experience you may be
requested to complete a DBS check in order to protect certain vulnerable groups. A number of jobs and
workplaces are exempted from the protection offered by the Rehabilitation of Offenders Act 1974.
> Your details Will be kept in accordance with the Data Protection Act 1998/2003. They will be
held securely and confidentially. They will be accessed by authorised personnel.
> DECLARATION
I authorise the Council to hold, collect and store the information contained within this form for
the purpose of assessing my application in accordance with the above.
I declare that the information that I have provided within this form is correct to the best of my
knowledge.
SIGNED:
DATE:
PLEASE RETURN THIS FORM TO THE FOLLOWING ADDRESS:
Entry to Employment Team
Workforce Development
Resources Directorate, Coventry City Council
1b Lamb Street
Coventry
CV1 4AE
Email: [email protected]
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