NEXT GENERATION CREATIVES PLACEMENT FORM (SCHOOLS)

NEXT GENERATION CREATIVES SCHOOLS – Student information form

Name

This field is for validation purposes and should be left unchanged.

This form should be completed by the designated teacher, careers lead, or work-experience coordinator. The information collected is used only to ensure that each student’s work-experience placement is safe, accessible, and appropriate. Sensitive data will be handled securely and deleted after the programme ends.

School Information

School Name:(Required)

Address(Required)
Street Address Address Line 2 City Postcode

Local Authority Area:(Required)

School Type (e.g. Academy, Maintained, Free School):(Required)

Designated School Lead Contact

Full Name:(Required)

Job Title:(Required)

Email(Required)

Direct Phone Number(Required)

Emergency Contact Number (for duration of placement):(Required)

Please provide an emergency out-of-hours contact number (if different):

Student Details

Student Full name

Year group

Age

creative interest (if any) :

Safeguarding, Health & Inclusion

Please complete this section for the named student to help us plan a safe and inclusive placement.

Provide only information that is relevant to the placement and that the employer may reasonably need to know.

Please select and add notes (tick as many as are applicable)(Required)
Access Needs (physical, environmental, or mobility)
Neurodiversity / Additional Learning Needs
Mental Health
Behavioural or Safeguarding Considerations
Language & Communication
Dietary Requirements
Travel & Independence
None applicable

Access Needs (physical, environmental, or mobility)
e.g. wheelchair use, need for lift/ramp access, quiet space, sensory considerations.

Neurodiversity / Additional Learning Needs
e.g. autism, ADHD, dyslexia, preferred communication or learning styles, reasonable adjustments.

Mental Health
e.g. anxiety, panic attacks, known triggers, helpful support strategies.

Behavioural or Safeguarding Considerations
e.g. known risk factors, pastoral concerns, or areas/postcodes to avoid.

Language & Communication
Does the student speak English as an additional language? List other languages and any communication needs.

Dietary Requirements
Only if relevant to placements providing food (students normally receive bursary to purchase own meals).

Travel & Independence
Can the student travel independently? Note any support or mobility concerns affecting attendance.

What is your preferred distance of travel for students to placements ?(Required)

If other, please provide details below:(Required)

Are there any specific times the student(s), in a 9am-5pm business day, cannot work?(Required)

Do you consent to this young person attending their placement outside of the standard 9-5 week day hours? (for example - later in the evening or on a weekend)

Yes

No

Other

If yes, please provide details below:

Is the student(s) required to wear school uniform for the placement?(Required)

Yes

No

Is the student(s) travelling from home or the school?(Required)

Home

School

Employer Documentation

Employer Documentation
Employer Documentation

Employers (host organisations) have completed a suitable and sufficient risk assessment and submitted this to Mission Accomplished before placement commences.

Parental / Carer Consent

The school confirms that parental consent has been obtained for each participating student and that parents/carers are aware of placement details, including travel arrangements and safeguarding procedures.

Bursary & Payment Information

Mission Accomplished will process bursary payments for students via the Post Office system, which are to be distributed by the designated school lead prior to placements.

Confirmation & Commitment

The school confirms that each student has demonstrated appropriate behaviour, attendance, and readiness to participate in work experience.

All the above is Confirmed by school lead

Confirmation & Commitment(Required)
By submitting this application, I confirm that:

Our school is committed to supporting the placement process.

We will select suitable students and ensure parental/carer consent is obtained.

We will prepare students for their placement experience, including workplace behaviour, safeguarding awareness, and travel arrangements.

We will provide a named emergency contact for students to use during the placement.

I agree to the Confirmation & Commitment

Data Protection Statement
Medical and safeguarding information will only be shared with the placement provider where necessary to ensure safety. All data will be stored securely in accordance with GDPR and Mission Accomplished’s Data Protection Policy.

We collect feedback from schools and students after each placement. In some cases, we may follow up for additional feedback. Please indicate whether you consent to being contacted for this purpose.

Yes, permission granted.
No, please do not contact after placement.

Name of Designated Lead:

Signature

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Date
MM slash DD slash YYYY

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