Please tell us about yourself:
Name: *
Email: *
Date of Birth: *
Phone Number: *
Address: *
Name of Parent/Guardian: *
Email of Parent/Guardian: *
Emergency Contact, Relationship & Contact Number: *
Please tell us some information about your School/College:
Work Experience Co-ordinator:
School/College: *
School/College Address:
Contact Number: *
Email Address:
To assess your placement needs, please provide us with the following information:
Placement Start Date: *
Placement End Date: *
What area of our business are you interested in working in? *
At which location would you like to carry out your placement? (Please use our store locator) *
Have you agreed a placement at one of our locations already?
Please us this section to note all disabilities, medical conditions and any additional support you may require during your placement. We require full disclosure so that we can properly assist you during your placement.
Are there any additional comments you wish to make?
