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Employer: Work Experience Application Form

Student Details

Employer Details

Work Experience Details

Company must have Employer’s Liability Insurance to enable placement to commence.

Employer Authorisation

I understand a representative of SHAPE will contact me before the placement commences.

Please type the letters and numbers displayed in the image into the textbox below to verify you wish to send this response. If you have difficulties reading the letters in the image below you can try a different image by clicking on it.

Verification Image