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Date
*
Name
*
Name
First Name
First Name
Last Name
Last Name
Student tel number (work experience students)
School
*
Forest Moor School
Green Meadows School
The Forest School
Manor CofE, York
Rossett School
All Saints, York
Joseph Rowntree
Vale of York
Archbishop Holgate
Fulford
York High School
Huntington
Harrogate Grammar School
St John Fisher
St Aidans
Malton School
Norton College
King James
Harrogate High School
Springwell Harrogate
Springwell Leeds
Parkside
Craven PRU
South Craven
Strive
Nidderdale School
Selby
Bingley Grammar School
Pebbles Care
Other
School
Start Date month/year
Year Group
*
9
10
11
12
13
14
Describe attendance at school
*
Very Good
Good
OK
Poor
Hardly Attend
Describe behaviour at school
*
Very Good
Good
OK
Up and Down
Always in trouble
What days should you normally attend school?
*
All days
Monday
Tuesday
Wednesday
Thursday
Friday
Other (please add more details in the comments/notes section below))
Describe what you like about school
*
Describe what you dislike about school
*
In the last 6 months, what have been your hobbies and interests?
*
Play sport
Watch Sport
See Friends
Gaming
Art and crafts
Cadets/ Scouts
Youth Club
Biking
Motorcross
Dancing/ expressive arts
Baking
Cooking
Animals
The outdoors
Gym
Social Media
Films and TV
Running
Reading
Swimming
Phone and Tech
Family support
None
Other
Other Hobbies
*
In the last 6 months, what things have you done at home
*
The dishes
Tidying Up
The laundry/ clothes/ washing machine
Preparing for dinner/ tea
Doing the shopping or bills
Taking the dog out, feeding or looking after pets
Cleaning up & hoovering
Making dinner & tea
Baby sitting
Cleaning the bathroom or kitchen
Cutting lawn or hedge
Picking up rubbish/ emptying bins
Making own bed
Take siblings to and from school
Help out the neighbours
Nothing
In the last 6 months, what life skills have you used? Give examples if necessary
*
Good Talker
Good Listener
Good team player
Work well on your own
Can follow instructions
Multi-tasker
Punctual
Show initiative
Good with kids
Good with animals
Good with people
Likes to make and fix things
Good handwriting/ illustrations
Good Routine
None
Other skills
*
Have you done any paid work, if so please tell us about it
*
Have you done any unpaid work or DIY, if so please tell us about it
*
Have you done any volunteering, if so please tell us about it
*
What do you think could hold you back in work?
*
Getting out of bed on time
Being nervous or anxious
Meeting new people
Speaking to customers
Answering the phone
Banter
Using the bus
Walking to work
Working full time hours
Being sat at a desk
Doing the same thing every day
getting to work on my own
Being put upon as the new person
Nothing
If applicable*, what are the expectations regarding transport to and from work experience
Not applicable
Student will walk
Student will use public transport
Parents will provide transport
Yes will provide support
School taxi
What work experience would you like to try
*
What are your career aims for the future?
*
Would you like to go to college?
*
Don’t know
No
Yes
Health considerations
*
Police and Crime/ Recreational drugs
*
Consent to store data, transport students and take photographs (where applicable).
*
signature
keyboard
Clear
I agree that the details recorded within my Careers and Work Experience Interview, are a true reflection of my situation
*
Requires further details
Yes
Comments or notes
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