Document Sample
					                                                             DURHAM UNIVERSITY
                                                                 Academic Office
                   TAUGHT PROGRAMMES

Please refer to Section 3.5.2 for guidelines

This agreement may be adapted by each department for its own use but must
include the headings below. It must be signed by each student undertaking a
placement as part of his/her degree programme and a copy must be kept by both the
student and the department concerned. The student must take this document with
him/her for reference while on the placement. Where applicable the SOCRATES/
ERASMUS learning agreement should be appended to this document.
General Details
Name of student
Degree programme
Academic year of placement: 200          – 200    ; Student’s level of study
Start date of placement ____________________________________________
End date of placement ________________________________________________
Dates of travel to placement ___________________________________________
Dates of travel at end of placement ______________________________________
Organisation hosting placement (name & location):
__                         ________________________________________
Contact or supervisor within placement host organisation (name, role, contact details)
Staff contact within Durham (name, role, contact details): ……..
Learning Outcomes of Placement and their articulation with the Module or
Programme Learning Outcomes (to be completed by department):

Learning Agreement
Give details of:
a)   the work which the student will undertake during the placement
b)   who will assess the work and when

c)   the Durham assessment criteria by which the work will be assessed (if

d)   the scale for translating marks from the host organisation into the Durham scale
     to contribute to degree classification (if applicable) *

* append if preferred
If it becomes necessary to change the agreed work pattern in any way (e.g. change
of project, supervisor or modules) or to finalise details after the student has arrived in
the placement location, the student must liaise closely with the home department and
copies of the changes agreed (e.g. email print-outs) must be kept with this learning
agreement by the student and the department.
Travel Cover
Note: Any student who fails his/her exams and is asked to withdraw from the
University is no longer a registered student and all university insurance cover
ceases. If you are in this position you must not travel to a placement or other
activity which was planned in the expectation of passing your exams. If you are
waiting for the result of a resit exam or an appeal you must not travel to a
placement or similar activity until and unless you have the result of that resit or
appeal and the outcome allows you to continue as a registered student.
Subject to the comments above, during the period between the start date and end
date of your placement (inclusive) you will be included in the University’s travel cover
where this has been confirmed by the Insurance Officer, subject to the limits
specified in the Travel Summary sheet supplied by your Department. You will also be
covered for your journey to the placement and your return journey back from the
placement provided that the length of time before and after your placement does not
exceed 7 days in total. If you will be spending time abroad before your placement
starts or after your placement ends that exceeds 7 days you can arrange cover for
these periods by accessing the website below.
If you are travelling abroad without a placement being arranged then the University
travel cover will NOT apply and you must take out separate travel insurance cover.
Once a placement is arranged the dates and details of your placement must be
communicated to the Insurance Officer by completing this form and the University
travel cover will apply for the period of your placement but only when this has been
confirmed by the Insurance Officer. Where several placements abroad may be
undertaken without returning to the UK the University travel cover will not apply to the
period between the last day of one placement and the first day of the next placement
and separate travel insurance must be effected for the intervening period.
Where you are only doing one placement abroad at the same institution you will be
covered for the vacation periods between terms, although if you return home during
this vacation period you will not be covered by the University’s travel cover whilst at
home but your flight from the placement to home and then back again will be
The start date of the placement is the first day of term or the first day of your work
placement and similarly the end of the placement is the last day of your last term
abroad or your last working day, unless you are doing placements at more than one
University/work place in which case please refer to the position above.
The following weblink can be used to obtain travel cover for travel that is not covered
by the University travel cover arrangements as outlined
You should note that the University does not provide any cover for any dangerous or
hazardous activities or sports and students must make their own insurance
arrangements for any such activities or sports. Hazardous activities and sports are
defined as deliberate exposure to needless danger (except in an attempt to save
human life), parasailing, parascending, white water rafting, abseiling, skiing off-piste,
tobogganing, gliding, hot air ballooning, parachuting, rock climbing, hang gliding,
potholing and caving and scuba diving.
Please note that students must take all reasonable care to avoid and prevent Bodily
Injury and Sickness which includes the use of all safety equipment and protective
head wear when undertaking any sports. Furthermore, any claim for Bodily Injury and
Sickness which arises directly or indirectly from or in connection with the use of
intoxicating liquor or drugs, solvent abuse or alcoholism is not covered.
The University travel cover does not apply to placements in the United Kingdom.
For further details about insurance see the relevant section in:
If you are starting travel to your placement from outside the UK please give details
below as this requires special insurance clearance:
      (a) country from which the trip will start ……………
      (b) details of any manual work involved
Active Monitoring
If you are travelling to a high risk area and do not feel able to rely upon local support
to protect your safety, Active Monitoring can be set up which will involve you phoning
Control Risks on a daily basis at a pre-agreed time. If you fail to make contact Control
Risks will escalate the situation to locate you.
Would you be interested in setting up Active Monitoring? YES/NO
Student’s Declaration
I understand my responsibility during the placement to:

(a)    commit myself fully to the work involved in the placement;
(b)    maintain contact with my department and keep the department informed of my
       contact details;
(c)    inform the department of any problems which cannot be resolved within the
       placement organisation;
(d)    conduct myself responsibly as a representative of the University.

I understand that I am subject to the academic and disciplinary regulations of the
University during the placement if I fail to fulfil my commitments or behave

I understand that I am also subject to the regulations and codes of professional /
academic practice (as appropriate) of the host organisation.

       The University takes every care to ensure that students are sent to placement
       locations which are safe and to offer the best advice on personal safety
       matters. However, health and safety legislation abroad may be less stringent
       than it is here and placements abroad will be controlled by the legislation of
       that country and not of the UK.
I have taken out personal travel insurance to cover any dangerous or hazardous
activities or sports and any other aspects of travel not covered by the University’s
insurance as indicated above .
I understand that:
    it is my responsibility to take reasonable care of my own health and safety while
     on the placement and of the health and safety of others. I will co-operate with
     the placement provider in complying with his legal duties with regard to health
     and safety matters;
    I am responsible for my safety with regard to private activities beyond the
     requirements of the placement itself, including day-to-day living (including
     travel), social and sporting activities;
    * I am responsible for my own health and safety in respect of selecting
     accommodation (where relevant) including the type and location of the
     accommodation and its general security;
    I am responsible for drawing to the attention of the Durham department as a
     matter of urgency any concerns I may have about the health and safety of the
     placement activities or of any accommodation which has been provided for me
     through the placement organisation.
(* delete if not applicable)

I have informed the University of any circumstances known to me (including any
medical condition) which might affect my ability to complete the placement

This section applies only to students who have arranged their own placement. Delete
if not applicable:

I have arranged my own placement activity and have provided the Department with
accurate information about the opportunities which it will offer and the arrangements
in place, and I understand that the placement has been approved on that basis. I
understand that the Department cannot be held responsible for any inaccuracies in
this information in respect of either the opportunities to fulfil the learning outcomes of
the placement or the general environment of the placement.

Risk Assessment

(To be completed by the department, in accordance with University Health and
Safety Manual Section F7 – Work Placements - see )
Level of Risk as per Control Risks website (
(Please refer to Claire Robinson in the Procurement Office if you are unsure as to the
level of risk after looking at the above website)
Placement 1)        Low* / Medium* / High* / Extreme* risk (* delete as applicable)
Placement 2)        Low* / Medium* / High* / Extreme* risk (* delete as applicable)
Placement 3)        Low* / Medium* / High* / Extreme* risk (* delete as applicable)
If Medium Risk or above please print off the information from the website and attach
to this form
Have the Foreign Office advised against travel? ( YES/NO
Where travel is to a country where the risk of travel is shown as Medium or above
please also include details of the measures taken to identify and reduce the risks in
this particular area on the Placement Risk Assessment form:
Placement Risk Assessment attached?                                  YES/NO

Signed:                                                      Date:

                       (for the department)

Name of departmental representative (printed)

Authorisation by Insurance Officer, Procurement Office, University Office

Cover for Trip:
Signature……………………………………………. Date…………………………………


Please note that travel which has not been fully authorised as above is NOT
covered by the University travel insurance arrangements.

This form must be submitted to the Insurance Officer at least one month in
advance of travel to enable insurance cover to be confirmed. This only applies
to placements involving travel outside the UK.

Where travel is intended to a Medium Risk area or above or where the Foreign
Office are advising against travel, please contact the Insurance Officer before
booking travel as the insurers may not cover this.