SEPnet Summer Placements 2019 - Employer Registration Form

1. Contact Details

Please complete the registration details below. Please note that you will not be able to return to this page once you have logged out. Please print and keep a copy of your registration details for your records. If you wish to register offline or have any queries, please email summerplacements@sepnet.ac.uk

Question Title

* 1. Name of company/institution

Question Title

* 2. Details of proposed supervisor(s)

Title

First name

Last name

Phone number

Email

Question Title

* 3. Company/institution

Company/institution

Address (of placement)

Address 2

City/Town

County

Postcode

Email

Phone Number

Question Title

* 4. Please indicate if help with finding accommodation can be provided or if a lift can be offered

Question Title

* 5. Details of main contact (if different from supervisor)

Title

First name

Last name

Phone number

Email

Question Title

* 6. Please indicate which contact person students should apply to (this person's email address and telephone number will appear on the project list circulated to students)