Student Placement Form

Complete this form, if you’re interested in doing your student placement with us, we look forward to hearing from you!Please note that If you are not a student, we ask that you fill out our volunteer form www.marys.org.uk/volunteer

Student Details

If you are not a student, please fill out our general volunteer application form https://www.marys.org.uk/volunteer

Name(Required)

First Last

Phone Number(Required)

Leave blank if they do not have a phone.

Email Address(Required)

Leave blank if they do not have a phone.

Address(Required)

Street Flat / Block / Estate ZIP / Postal Code

Do you have a current DBS/ are you on the DBS update system?

I have a DBS

I would need a DBS

Unknown

Details of current study

Name of School/ College/ University

Please choose one(Required)

Secondary education: I am 16 and under and looking for work experience

Further education: I am 16+ looking for a placement

Higher education: I am 18+ studying a Youth Work and/or Community Course looking for a placement

Other (please specify in your application)

Placement details

Please fill out as much of the following as possible

Length of placement you are looking for

Dates of placement (if known)

Tell us a bit about you

Do you have any experience of working with young people or other transferable skills?

You don’t necessarily need to have this experience, as we can train you, this is just for us to get an idea of the skills you may already be bringing

What would you like to get from this placement?

Equality & Diversity Data

Gender

Sexual Orientation

Nationality

Ethnicity

Disability

Additional Requirements

Is there anything else that we need to know in order to support you in your role as a Volunteer?

Medical Requirements

e.g. Asthma, Allergies

Dietary Requirements

e.g. Vegetarian, Halal, Vegan

Cultural Requirements

Other Inclusion Needs