Application Form for Host Organisations - Employment and Internships Programme

Questions with a red asterisk ( ) must be answered.

SECTION 1: Organisation Information

Organisation Name

Organisation Type

Other Organisation Type

Registration Number (if applicable)

Website

Social Media Handles

Address

Street

Town or city

Local Authority Area

Postcode

SECTION 1: Organisation Information

Contact Person for Internship Placement:

First Name

Last Name

Job Title

Email Address

Phone Number

How do you prefer to be contacted?

SECTION 2: Internship Placement Details

Please fill in the below information for each role you are able to offer. To add information about more than one role, click the 'add another placement' link in the bottom right.

Note that our internships are supported for 420 hours over a year (part time /fulltime).

Proposed Internship Role Title

Department

How many interns can your organisation host in this role?

Brief Description of Internship Role

Internship Location

Location Details

Start Date

End Date

Weekly Hours

SECTION 2: Internship Placement Details

Will the intern(s) receive supervision and mentoring support?

YesNo

Please describe the support you can offer

Please explain why you are unable to offer support

SECTION 2: Internship Placement Details

Can you confirm you will be able to make reasonable adjustments to support disabled interns?

YesNo

Please give examples of the reasonable adjustments you can make

Please explain why you are unable to make reasonable adjustments

SECTION 3: Organisational Commitment

Why is your organisation interested in hosting an intern?

SECTION 3: Organisational Commitment

Has your organisation previously hosted interns, apprentices or placements?

YesNo

Please give details about this previous experience

SECTION 3: Organisational Commitment

Safeguarding and Inclusivity

Does your organisation have safeguarding policies in place?

YesNo

Please explain why your organisation does not have safeguarding policies in place

Is your workplace inclusive and accessible?

YesNo

Please explain how your organisation is not inclusive or accessible

You may attach any relevant documentation here (e.g., internship descriptions, accessibility policies, etc.)

Tick this box if you would like to upload more than one file

SECTION 4: Declaration

I confirm that the information provided is accurate to the best of my knowledge, and my organisation is committed to supporting the aims of the Internships Programme.