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As you will be going on Work Experience, we need some information from you so that we can find the kind of placement that best suits you.

Please answer all of the questions clearly. Think carefully when making your choices as once you have given in this form you cannot change your mind. Relate to the career that you would like to pursue later or the courses studied at advanced level. Allocation will follow priority put down.

First Name :
Last Name :
Date of birth :
Gender : Male Female
School:
Year group:
Parent/ Carer contact no:
Parent/ Career email:

Please make three choices from the following (Write 1st / 2nd / 3rd Choice) :

Administration, Business and Office Work Financial Services Performing Arts
Building and Construction Healthcare Personal and Other Services including health and beauty
Catering and Hospitality Languages, Information and Culture Retail Sales and Customer Services
Computers and IT Legal and Political Services Science, Mathematics and Statistics
Design, Arts and Crafts Leisure, Sport and Tourism Security and Armed Forces
Education and Training Manufacturing and Production Social Work and Counselling Services
Engineering Marketing and Advertising Transport and Logistics
Environment, Animals and Plants Media, Print and Publishing Other

Are you willing to travel to Greater Kampala and surrounding areas (e.g. Entebbe, Mpigi, Wakiso or Mukono)?

Yes No

Are there any special circumstances that we should bear in mind? (E.g. difficulty with language, hearing, mobility, etc.)
If Yes please state below.

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