APPLICATION FORM


For Work Experience Placement

Personal Details
Name:
Present Address:
Post Code:
Country:
Tel:
Fax:
Email:
Nationality:
Date of Birth:


Work Experience Requirements
Preferred Dates

Commencing:

Finishing:

How Many Weeks?

Minimum:

Maximum:


Purpose of Work Experience?
Describe the type of experience you would like to receive:
Preferred Company Activity:
Preferred Company Department:
Any other information you wish to supply:


Additional Information
Do you wish us to arrange accommodation for you during your stay?
Yes Please complete the Accommodation Form
No 
Is it necessary for you to receive remuneration?
Yes Please specify minimum weekly amount required £:
No




After submitting this form, please send your C.V. and registration fee to the address below

You may send your C.V. as an email attachment.

EAGLE UK WORK EXPERIENCE PROGRAMME
Eagle House, 177 Stourbridge Road,
Halesowen, West Midlands B63 3UD. England.
Tel: 44 (0)121 585 6177
Fax: 44 (0)121 585 7441
Email: info@eaglewep.co.uk