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New Employer Agreement Registration
Location
*
UK
Europe
International
Address
*
Post Code
*
Student(s) Name(s)
*
Form Completed By
Organisation Name
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Industry
Accounting
Admininstrative
Banking
Business Development
Catering
Charity
Communications
Construction
Consulting
Customer Services
Education
Elect
Electronics
Employment
Energy
Engineering
Entertainment
Event
Finance
Government
Healthcare
Hospitality
Human Resources
Insurance
Legal
Logistics
Media
Management
Marketing
Not For Profit
Other
Real Estate
Recruitment
Recreation
Retail
Sales
Technology
Telecom
TRAVEL & TOURISM
Select one or more; Press & hold cntrl / Press & hold cmd and select
Your Name
*
Your Position
*
Your Phone
*
Your Email
*
Read Letter
*
I have read and agree to
the employer responsibilities
Nominated Contact
Who is your nominated contact for compliance with these requirements of health and safety legislation?
Position
Health and Safety Policy
Does your organisation have a written Health and Safety Policy?
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Yes
No
Do you have a policy regarding health and safety training for people working in your undertaking, including use of vehicles, machinery and equipment, and will you provide all necessary health and safety training along with supervision and free personal protective equipment for our placement student(s)?
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Yes
No
What health and safety instruction/ training will the work placement be given? (including induction and training relating to pandemic measures)?
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Do you have any legal proceedings against you with regards to any Health and Safety issues?
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Yes
No
Risk Assessment
Do you carry out risk assessments of your work practices, including manual handling and display screen equipment to identify possible risks, to employees (including students) within your undertaking?
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Yes
No
Are risk assessments kept under regular review and are the results implemented?
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Yes
No
Will the student be undertaking any higher risk activities?
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Yes
No
Insurance
Is Employer Liability Insurance and Public Liability Insurance held?
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Yes
No
Is the student deemed to be an employee for the purposes of these insurance policies?
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Yes
No
Does your insurance cover liability for injuries or sickness suffered by placement/work experience students attributable to their duties within your organisation and do you have first aiders available in the student’s workplace?
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Yes
No
Accidents and Incidents
Is there a formal procedure for reporting and recording accidents and incidents (in accordance with RIDDOR in the UK or other country legislation if an international placement)?
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Yes
No
Have you procedures to be followed in the event of serious and imminent danger to people at work in your undertaking?
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Yes
No
Will you report to the University all recorded accidents involving our students?
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Yes
No
Will you report to the University any sickness involving our students which may be attributable to the work?
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Yes
No
Insurance Provider
Policy Number
Limit Of Indemnity
International
Will the placement require extensive travel to other countries?
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Yes
No
Will the placement/experience be required to travel regularly as part of their work?
Yes
No
If the answer to the above question was YES, please give details below
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