What is the work placement agreement form template?
Before a student starts a work placement, three parties need to agree the same things: when and where the student works, who supervises them, what they'll do and learn, and how they'll be kept safe. When that agreement is spread across emails, details like the risk assessment or insurance are easy to miss.
This template brings it together over four pages. The student and school give contact details and the placement tutor. The employer page records the organisation, address, supervisor, dates, days, daily hours, pay and whether work is on site or remote. The third page sets out tasks, learning goals, assessment and check-ins. The last page covers the health and safety induction, risk assessment, hazards, protective equipment, extra arrangements for under-18s, insurance, support needs and an emergency contact, then each party agrees to its commitments and signs.
The signed agreement is saved as a PDF in your FileIt vault, alongside any insurance certificate the employer uploads.
- Best for
- Schools, colleges and universities arranging work experience, internships or industrial placements
- Filled in by
- Student, workplace supervisor and placement tutor
- Time to complete
- About 15-20 minutes in total
- Includes
- Pay rate follow-up, under-18 arrangements, insurance upload, three commitments and signatures
Who uses a work placement agreement form?
- A secondary school arranges a two-week work experience week
- A college sets up a weekly placement for a vocational course
- A university agrees a year-long industrial placement
- An employer hosts several students and keeps each agreement on file
- A placement team checks insurance before a student starts
- A tutor records learning goals that the placement is assessed against
Questions on this work placement agreement form
44 questions over 4 pages · includes signature, file upload, conditional questions, multiple pages, consent checkbox.
1 Student & school
- Student*
- Student email*
- Student phone*
- Student date of birth*
- Course or programme*
- School, college or university*
- Placement tutor*
- Tutor email*
- Tutor phone
2 Employer & schedule
- Employer or organisation*
- Placement address*
- Workplace supervisor*
- Supervisor's job title*
- Supervisor email*
- Supervisor phone*
- Start date*
- End date*
- Days of the week* Monday · Tuesday · Wednesday · Thursday · Friday · Saturday · Sunday
- Daily start time*
- Daily finish time*
- Is the placement paid?* Unpaid · Paid · Expenses only
- Pay per hour* asked only when it applies
- Where will the work happen?* On site · Remote · Hybrid
3 Tasks & learning goals
- Main tasks and responsibilities*
- Learning goals*
- How the placement will be assessed Supervisor report · Reflective log or diary · Tutor visit or call · Project or portfolio · Presentation · Not assessed
- Supervisor and student check-ins* Daily · Weekly · Every two weeks · Monthly
4 Health, safety & signatures
- Will the student get a health and safety induction on the first day?*
- Has the employer done a risk assessment that covers this student's tasks?*
- Significant hazards and controls
- Protective equipment provided
- Is the student under 18?*
- Extra arrangements for a young worker* asked only when it applies
- Insurance in place* Employer's liability insurance · Public liability insurance · School or university placement insurance · Professional indemnity
- Insurance certificate
- Health conditions or support needs the supervisor should know about
- Student's emergency contact*
- Emergency contact phone*
- Student*
- Student's signature*
- Employer*
- Supervisor's signature*
- School*
- Tutor's signature*
The work placement agreement form, page by page
1 Student & school
The student's name, email, phone and date of birth, their course and school, college or university, and the placement tutor's name, email and optional phone.
2 Employer & schedule
Employer, placement address, the workplace supervisor's name, job title, email and phone. Start and end dates, days of the week, daily start and finish times, whether it's paid (paid asks for an hourly rate) and whether work is on site, remote or hybrid.
3 Tasks & learning goals
Main tasks and responsibilities, learning goals, how the placement will be assessed and how often the supervisor and student check in.
4 Health, safety & signatures
Whether there's a first-day induction and a risk assessment, hazards and controls, protective equipment, and whether the student is under 18, which asks for extra arrangements. Insurance in place, an optional certificate upload, support needs and an emergency contact. An absence and incident paragraph, then the student, employer and school each agree to a commitment and sign.
Make the template yours
- Change the pay currency to your own
- Edit the absence paragraph to match your school's procedure
- Add your country's young worker rules to the under-18 question's help text
- Remove the pay questions for unpaid work experience programmes
- Add a parent or guardian signature for younger students
- Send it as a personal link so all three parties sign the same response
Tips for a better work placement agreement form
- Agree the learning goals with the tutor before the employer signs
- Check insurance before the start date, not on it
- Give the student the supervisor's phone number before day one
- Keep the risk assessment with the agreement in your vault
- Have your placement team check the commitments against your own policy
Every response becomes a PDF in your vault
The signed agreement is saved as a PDF in your vault with any insurance certificate attached, and the placement team is emailed. The student receives a copy.
From the Responses table you can see every placement by employer and dates and export a CSV for visit planning.
- Start from this template. It opens in the FileIt Forms designer — change any question, add pages, set the rules for when questions appear.
- Share it. Turn on a public link, or send it to people by email, each with their own link. They don’t need a FileIt account.
- Get the answers as PDFs. Each response is saved as a PDF in the vault folder you choose, with uploaded files attached — and listed in a Responses table you can export to CSV.
Work placement agreement form: frequently asked questions
Is this work placement agreement template free?
Yes. It's one of the Forms app's starter templates, available on every FileIt account, including the free plan.
How do three people sign one form?
Fill it in together, or pass the device round. The student, workplace supervisor and tutor each have their own commitment and signature.
Does it cover students under 18?
It asks whether the student is under 18 and, if so, what extra arrangements are in place. Check your local rules for young workers.
Is it a contract of employment?
No. It records what the parties agreed for the placement. Employment and legal obligations depend on your country and situation.
Can the employer upload an insurance certificate?
Yes. There's an optional upload for up to two files.
Do employers need a FileIt account?
No. Everyone fills it in from a link.