Internship Opportunities Available!

We are looking for creative individuals who want to build their Portfolio, Skills & CV, by offering an Internship supporting real world projects within Health & Care.

If this is something you are interested in, please complete the below application form.

*Please note, we have limited availability therefore may not be able to offer every applicant an opportunity*

Applicants must be at least 16 years old

Internship Application

Form

Please read before completing this application form. Your electronic signature at the end of this form will be verification that you have read this information.

Please be aware that an application for an Internship does not guarantee success, although we will endeavour to support your request.

Please note the application process will close on Friday 29th March at 5pm.

All elements of this form must be completed

Personal Details

First Name(Required)

Surname(Required)

Address(Required)

Street Address Address Line 2 Town/City County Postcode Country

Telephone(Required)

E-mail Address(Required)

Date of birth *Please note that all applicants must be a minimum of 16 years of age(Required)

DD slash MM slash YYYY

Endorsement or Reference(Required)

In the space above, please provide an email address for an individual who will be happy to endorse your application for an Internship. This should be a teacher, tutor, Work Coach, colleague or professional, who has known you for 2 years or longer and who is not member of your family. Please note that we will be contacting this person for their verification and your Internship application is subject to us receiving confirmation from this individual. The email address provided should be educational or professional, not for example, hotmail or gmail.

Do you have any current medical conditions or health issues we should be aware of that would prevent you from undertaking certain tasks? These could include hidden disabilities as well as visible. Please advise of any resonable adjustments we can make to support your experience.(Required)

Yes

Do not wish to disclose

If 'Yes', please provide details:

Current College or University:(Required)

Year Group:

*If Applicable*

Course of Study (e.g. GCSEs, A-Levels, T-Levels, BSc, etc.):

*If Applicable*

Is the placement you are seeking a requirement for a T-Level qualification?(Required)

Yes

*Please note, if you are applying for a T-level placement, please contact your Tutor*

If you are not in education, please tick below:

I am not in education

If you are in employment and not in education, please give details (Job Title and Employer):

Internship Details

Area of Interest:

Social Media Campaigns

Podcasts

E-Learning

Animations

Videos

Website Content Creation

Flyde currently do not accept work experience students at this time.

Please briefly outline why you are interested in undertaking an Internship (minimum of 100 words)(Required)

Emergency Contact Details

Name of emergency contact:(Required)

Relationship to emergency contact:(Required)

Telephone number of emergency contact:(Required)

Agreement

Internship applicant to complete. Please sign below to show agreement to the following statements:

All the information given on this form is correct;
I give consent for the Careers & Engagement Team to store and file this information electronically and on paper;
I understand that I have the right to request erasure of this information;
I will hold in confidence any information about the employer, staff, patients and patient’s families which I may obtain during the placement;
I am aware of the acute nature of the placement environment and that I may be exposed to unexpected situations.

Please print your name as a way of confirming you agree to the above conditions.(Required)

Date(Required)

DD slash MM slash YYYY

Equality, Diversity and Inclusion Monitoring

We collect this information to monitor the diversity of our work experience applicants as part of our effort to ensure that we are accessible to all. You do not need to share any of this information with us but if you do, it can help us to make improvements to how we promote and co-ordinate our work placement opportunities across Lancashire & South Cumbria. If you would prefer not to share this information, please select the 'prefer not to say' option.

Gender(Required)

Female

Male

Non-binary

Gender Neutral

Transgender

I prefer not to say

If you choose to self-describe, please give details below:

Disability(Required)

Yes

If 'Yes', please provide details:

Learning Disability(Required)

Yes

If 'Yes', please provide details:

I would describe my ethnic group as:(Required)

White

Mixed

Asian/ Asian British

Black/ Black British

Chinese

Other

If not listed, please state:

Sexual Orientation(Required)

Bisexual

Gay or Lesbian

Heterosexual or Straight

Prefer not to disclose

A sexual orientation not listed

If not listed, please state:

Are you currently or have been in care of the local authority / foster care?(Required)

Yes

Do not wish to disclose

Are you a care leaver?(Required)

Yes

Do not wish to disclose

Rehabilitation of Offenders Act

Because of the nature of the work experience placement for which you are applying, this post is exempt from the provisions of section (2) of the Rehabilitation of Offenders Act 1975. Applicants are therefore required to disclose any criminal convictions, bind overs or cautions.

Have you been convicted of a criminal offence, been bound over, warned, cautioned or reprimanded or are you currently the subject of any police investigation?(Required)

If ‘Yes’, please provide brief details:

Disclosure of the above will not automatically exclude you from gaining a place on this programme. However, failure to disclose on this form any of the above will result in your removal from the placement. All information provided on this form will be treated in strict confidence.

Internship Application

Form

Personal Details

Internship Details

Emergency Contact Details

Agreement

Equality, Diversity and Inclusion Monitoring

Rehabilitation of Offenders Act

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