Register your interest for a placement with NELFT

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Register your interest for a placement with NELFT

Expression of interest

If you would like to be considered for a work experience placement within NELFT please complete the 'Expression of interest' form below

Expression of interest form

Note: Questions marked by * are mandatory

*This is a mandatory field. Full name

*This is a mandatory field. House number and street name

*This is a mandatory field. Town/City

*This is a mandatory field. Postcode

*This is a mandatory field. Date of birth

*This is a mandatory field. Age

16-20
21-30
31-40
41-50
51-60
61-64
65 & over
Rather not say

*This is a mandatory field. Telephone number

*This is a mandatory field. Email address

*This is a mandatory field. Examination grades/ Predicted grades

*This is a mandatory field. The name of the school, college or university you currently attend

*This is a mandatory field. The name of the Sixth Form College or university you are applying to

*This is a mandatory field. Please state the specific dates you wish to undertake the placement (you must allow a 6-8 weeks’ notice for any placement)

*This is a mandatory field. Tell us why you would like a placement

*This is a mandatory field. Tell us the service type you wish to be placed in

Medicine
Nursing
Physiotherapy
Occupational Therapy
Speech and Language Therapy
Administration

*This is a mandatory field. Other

*This is a mandatory field. For a full list of NELFT services please visit http://www.nelft.nhs.uk/our-services

*This is a mandatory field. Have you already approached a NELFT service requesting work experience? If yes, please state the service and name of contact

*This is a mandatory field. Tell us about your future career plans

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