Emergency Contact

Pupil Details
Pupil Name _____________________________________ Tutor Group ______________________________
Home Telephone Number _________________________ Work Telephone Number ___________________

School Details
School Name _____________________________________________________________________________
School Address ____________________________________________________________________________
Work Experience Co-ordinator/Teacher ______________

Head Teacher _____________________________

School Telephone Number ________________________

School Fax Number ________________________

Parent/Guardian Details
Contact Name __________________________________

Relationship to student _____________________

Home Telephone Number _________________________ Work Telephone Number ____________________

Mobile Telephone Number _________________________

Introduction

Introduction to Pupils
This logbook will help you record your experiences and achievements on these placements. You will need
it for follow up work back at the Academy and for your Record of Achievement. Please fill it in carefully
and make sure that you take it with you each day.
Your diary will help to show that you have experienced some very important aspects of work-related
learning.

Introduction to Employers
Please help the pupil to complete the appropriate pages of this logbook to enable them to reflect upon their
experiences and to have a record for use upon returning to the Academy. It would be helpful if the pupils
supervisor could complete the enclosed report (pages 14, 15 and 16) and you as the employer could provide
a letter of reference to be included in the pupils Record of Achievement. This should be sent to the Work
Experience Co-ordinator at the Academy.

Aims, Advice & Guidance

The aims of the work placement experience fall into one or more of the following categories:

Explore a career option

Research for an assignment

Personal developments e.g. improve communication skills, acquire more confidence etc.,

University requirement to have relative experience for the proposed course of study
Students are required to summarise their activities on the diary sheets. Additional sheets are available from
Careers. Students are also required to ensure the Employers Report is complete. Make sure your booklet is
complete before passing it to your supervisor for completion. Show the letter and booklet to your supervisor
on the first day. The completed booklet can be returned to the student or directly to the Academy using the
enclosed envelope.
Students should be aware that they will be called on to make a 10-15 minute presentation about their work
placement experience. Keeping a record of their activities will assist in the preparation of a presentation.

Health & Safety

Students have a legal responsibility under the Health & Safety at Work Act (1974) to conduct themselves in
a manner that does not endanger themselves or others. To meet their responsibilities, students will need
to observe the safety rules and procedures of the organisation.

Equal Opportunities
The Academy is commited to the principle and practice of equal opportunity for all students. The Academy
will not condone or tolerate victimisation or harassment of students. If, at any time students have cause for
concern they should contact the Director of Careers or their Personal Tutor who will investigate any reported
concerns.
In the event of a problem arising, students can do one of two things:

Discuss the problem with their supervisor and endeavour to resolve it to everyones satisfaction

Telephone the Academy (9am - 5pm) and speak with the Director of Careers
Academy staff and/or Industrial Consultants will visit you during your work placement unless you are outside
the West Midlands area, in which case telephone calls will be made to enquire about your progress.
Please remember to telephone your work placement and
the Academy if you are going to be absent for any reason
(giving an expected date of return).
It is traditional for students to thank their host organisations
either formally by letter, or with a small gift such as a box of
chocolates or cakes etc., Finally, remember Smile and the
world smiles with you.
Best wishes for a successful work placement experience.
Gareth Howell
Director of Careers

Health & Safety For Students

Introduction
Employers and employees have a legal responsibility under the Health & Safety at Work Act (1974) to work
together to ensure a safe and healthy workplace. The Act also covers visitors to the workplace, apprentices
and students on work placement. Anywhere that people work, whether part time or full time, is deemed to
be a workplace e.g. factories, offices, shops, dentists, nurseries and schools.
Students will know about the procedures set down by the Academy to ensure their health and safety which is
contained in the Health and Safety Policy, compiled by the Academy and implemented by the Academys
Safety Manager. Organisations employing five or more people must have a written policy.

Work Placement Arrangements

Organisations used for work placement by the Academy have been vetted to ensure they have the
procedures and practices in place to ensure their workplace is safe and healthy and conforms to the Health &
Safety at Work Act (1974). Prior to commencing work placement, students will attend a presentation on
their roles and responsibilities.

Students on Work Placement

Students who attend a pre-placement interview should ask about safety arrangements e.g. what should they
wear, who will be their supervisor, who is responsible for first aid?
When students commence work placement they will be given an induction which will include the safety
requirements that will apply to them during the period of work placement, including the procedures for
recording and reporting accidents. All accidents must be reported to the provider and the Academy.
Students are required to complete a Health & Safety Questionnaire during the first week and show it to the
Industrial Consultant or Academy staff (on their first visit).
Students on multi-placements must complete a form for each placement.
Students on placement outside the area and not likely to be visited must post their forms to the Academy at
the end of the two week placement.
Students having any questions or needing clarification on any matter should speak with the Director of
Careers.

Health & Safety Declaration

Prior to commencing work placement, students will be given guidance and instruction concerning their duties
and responsibilities regarding Health & Safety at work while on placement.
On completion of the above, students will be required to sign the declaration below.
I ______________________________________ have been given a copy of Guidance & Arrangements for
Students on Work Placement (Health & Safety).

I have received verbal instructions and understand the objectives of the Health & Safety at Work Act (1974).
I am fully aware of my duties and responsibilities associated with my work placement.
Signed _________________________________________________________

Date ______________

Preparation
Preparing for your pre-visit

You or your teacher make an appointment

Get there in plenty of time

Dress appropriately

Make sure that you take this logbook with you

Ask about your first day

Check what work you will do

Fill in this sheet

Placement 1
I have phoned to make an appointment (please tick)
Telephone number _____________________________

Date __________________________________

I will visit on __________________________________

at ____________________________________

How will I get there? _____________________________________________________________________

I will speak to ________________________________

He/She is ______________________________

Placement 2
I have phoned to make an appointment (please tick)
Telephone number _____________________________

Date __________________________________

I will visit on __________________________________

at ____________________________________

How will I get there? _____________________________________________________________________

I will speak to ________________________________

He/She is ______________________________

Health & Safety For Students

Please complete during the first week of each placement:
Week 1
Organisation ___________________________________________________________________________
On your first day

Did you attend an induction session?

Yes

No

Did the induction cover safety matters?

Yes

No

Do you know the evacuation drill?

Yes

No

Do you know your assembly point?

Yes

No

No
Give details of other safety related requirements Yes
e.g. reporting accidents and first aid facilities
Signed ____________________________________________________ Date _______________________

Week 2
Organisation ___________________________________________________________________________

On your first day

Did you attend an induction session?

Yes

No

Did the induction cover safety matters?

Yes

No

Do you know the evacuation drill?

Yes

No

Do you know your assembly point?

Yes

No

No
Give details of other safety related requirements Yes
e.g. reporting accidents and first aid facilities
Signed ____________________________________________________ Date _______________________

Student Objectives
What do you expect to gain from your Work Placement?
Make a list below, using any of the suggestions plus others you may have. The list can be changed as you
go through your work placement. At the end of your work placement, indicate by ticking YES or No if your
objectives were achieved.
Suggestions:

Achieved

I want to see how IT is used

Yes

No

I want to develop my self-confidence

Yes

No

I want to test my interpersonal skills

Yes

No

Your Objectives:

Achieved

_____________________________________

Yes

No

_____________________________________

Yes

No

_____________________________________

Yes

No

Yes

_____________________________________

No

Your comments: ___________________________________________________________________

Suggestions:

Achieved

I want to see how IT is used

Yes

No

I want to develop my self-confidence

Yes

No

I want to test my interpersonal skills

Yes

No

Your Objectives:

Achieved

_____________________________________

Yes

No

_____________________________________

Yes

No

_____________________________________

Yes

No

_____________________________________

Yes

No

Your comments: ___________________________________________________________________

Week 1 Diary
Please record the main tasks done each day.
Keep your diary up to date by filling it in at the end of each day.
Monday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Tuesday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Wednesday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Thursday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Friday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Week 2 Diary
Please record the main tasks done each day.
Keep your diary up to date by filling it in at the end of each day.
Monday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Tuesday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Wednesday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Thursday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Friday
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________

Student Reaction - Week 1

Did you find the experience (please tick)
Interesting

Yes

No

Boring

Yes

No

Enjoyable

Yes

No

Varied

Yes

No

Demanding

Yes

No

Helped with career choice

Yes

No

Comments _________________________________________________________________________
__________________________________________________________________________________

About your placement

Were staff friendly/helpful?

Yes

No

Were you kept fully occupied?

Yes

No

Would you recommend this placement to other students?

Yes

No

If no, please outline reasons ___________________________________________________________

__________________________________________________________________________________
How difficult did you find the tasks set? _________________________________________________
__________________________________________________________________________________
What was your journey like? __________________________________________________________
__________________________________________________________________________________

Look back at the things you expected to achieve from work experience (refer to page 6). Did you achieve
them?
1.

___________________________________________________________________________

2.

___________________________________________________________________________

3.

___________________________________________________________________________

Student Reaction - Week 2

Did you find the experience (please tick)
Interesting

Yes

No

Boring

Yes

No

Enjoyable

Yes

No

Varied

Yes

No

Demanding

Yes

No

Helped with career choice

Yes

No

Comments _________________________________________________________________________
__________________________________________________________________________________

About your placement

Were staff friendly/helpful?

Yes

No

Were you kept fully occupied?

Yes

No

Would you recommend this placement to other students?

Yes

No

If no, please outline reasons ___________________________________________________________

__________________________________________________________________________________
How difficult did you find the tasks set? _________________________________________________
__________________________________________________________________________________
What was your journey like? __________________________________________________________
__________________________________________________________________________________

Look back at the things you expected to achieve from work experience (refer to page 6). Did you achieve
them?
1.

___________________________________________________________________________

2.

___________________________________________________________________________

3.

___________________________________________________________________________

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Employer Reaction- Week 1

Pupils name _______________________________________________________________________
Would you please fill in the following report, preferably discussing it with the pupil first. This information is
confidential to the pupil, to the school and to yourself.
Attendance

Good

Acceptable

Needs Attention

Punctuality

Good

Acceptable

Needs Attention

Suitability of dress

Good

Acceptable

Needs Attention

Acceptable

Needs Attention

Acceptable

Needs Attention

IT skills (if appropriate) Good

Acceptable

Needs Attention

Numeracy (if appropriate) Good

Acceptable

Needs Attention

Working without supervision Good

Acceptable

Needs Attention

Working as part of a team Good

Acceptable

Needs Attention

Ability to communicate Good

Behaviour

Good

Working safely

Good

Acceptable

Needs Attention

Flexibility

Good

Acceptable

Needs Attention

Interest shown

Good

Acceptable

Needs Attention

Organising own work

Good

Acceptable

Needs Attention

Attitude to work

Good

Acceptable

Needs Attention

Relationship with supervisor Good

Acceptable
Needs Attention
General comments (Employers are invited to write a letter which pupils will be able to put in their record of
achievement if they so wish).
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Company name ____________________________________________

Date __________________

Signature of supervisor ______________________________________

Date __________________

Position ___________________________________________________________________________
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Employer Reaction- Week 2

Pupils name _______________________________________________________________________
Would you please fill in the following report, preferably discussing it with the pupil first. This information is
confidential to the pupil, to the school and to yourself.
Attendance

Good

Acceptable

Needs Attention

Punctuality

Good

Acceptable

Needs Attention

Suitability of dress

Good

Acceptable

Needs Attention

Acceptable

Needs Attention

Acceptable

Needs Attention

IT skills (if appropriate) Good

Acceptable

Needs Attention

Numeracy (if appropriate) Good

Acceptable

Needs Attention

Working without supervision Good

Acceptable

Needs Attention

Working as part of a team Good

Acceptable

Needs Attention

Ability to communicate Good

Behaviour

Good

Working safely

Good

Acceptable

Needs Attention

Flexibility

Good

Acceptable

Needs Attention

Interest shown

Good

Acceptable

Needs Attention

Organising own work

Good

Acceptable

Needs Attention

Attitude to work

Good

Acceptable

Needs Attention

Relationship with supervisor Good

Acceptable
Needs Attention
General comments (Employers are invited to write a letter which pupils will be able to put in their record of
achievement if they so wish).
__________________________________________________________________________________
__________________________________________________________________________________
__________________________________________________________________________________
Company name ____________________________________________

Date __________________

Signature of supervisor ______________________________________

Date __________________

Position ___________________________________________________________________________
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Action Plan
Use this page to write down what you are going to do to build on your
Work Experience.
Action

Who or Where Could Help?

e.g. Where can I get information about a job in...?

Careers Advisor
Look in Careers Library

Take this with you to your careers interview to help you complete your action plan.

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Notes/Contacts
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______________________________________

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