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Work Placement Form

WORK PLACEMENT FORM

    Section 1: Contact Details

    Organisation's Name* :

    Fax No* :

    Name of Authorised Person to Contact* :

    Email* :

    Position* :

    Training Location Area* :

    Contact No* :

    Contact Address* :

    Section 2: Training Opportunities to be offered by the Organization

    Training Field - Electrical* :

    Training Field - Instrumentation* :

    Training Field - Mechanical* :

    Training Field - Oil & Gas* :

    Section 3: General Information

    Working Hours* :

    From:

    To:

    Working Dates* :

    From:

    To:

    Can Student Use the Organization Transportation* :

    Can your Organization provide uniform/ coverall for students* :

    Scanned Signature* :

    Date* :