Work Based Learning Agreement Example
Student Name :
PERIOD OF PROPOSED PLACEMENT
From : To :
Agreed number of working days : Total hours :
DETAILS OF PLACEMENT PROVIDER
Name of Placement Supervisor Mentor : Position Held : Telephone Number : Email :
DETAILS OF ACADEMIC MENTOR
Name : Telephone number : Email :
AGREED PROGRAMME OF WORK FOR PLACEMENT ( please outline expected duties to be performed ).
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