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    This document is a placement registration form for a student at Midlands State University to complete work-related learning. It contains information such as the student's name and registration number, contact details, program of study, and details of the company where the placement will take place including the name, physical address, and contact information for the student's workplace supervisor. At the bottom is a confirmation section to be signed and dated by the supervisor confirming the student's start and end dates for the placement.

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    This document is a placement registration form for a student at Midlands State University to complete work-related learning. It contains information such as the student's name and registration number, contact details, program of study, and details of the company where the placement will take place including the name, physical address, and contact information for the student's workplace supervisor. At the bottom is a confirmation section to be signed and dated by the supervisor confirming the student's start and end dates for the placement.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    103 views1 page

    Placement Registration Form PDF

    Uploaded by

    WebWeb
    This document is a placement registration form for a student at Midlands State University to complete work-related learning. It contains information such as the student's name and registration number, contact details, program of study, and details of the company where the placement will take place including the name, physical address, and contact information for the student's workplace supervisor. At the bottom is a confirmation section to be signed and dated by the supervisor confirming the student's start and end dates for the placement.

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    © All Rights Reserved
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    of 1

    MIDLANDS STATE UNIVERSITY

    WORK-RELATED-LEARNING OFFICE

    Placement Registration Form


    Student Details
    *Student Registration Number: !!!!!!!!!!!!!!!!!!!!!!!!!..
    (e.g. R0377777)

    Student Name:

    !!!!..!!!!!!!!!!!!!!!!!!!!!!!!
    (e.g. Exavier Chabata)

    Contact Tel No.......................................................... Buss land line....................................


    Programme:.....................................................................................................................
    Company Name:

    !!!!!!!!!!!!!!!!!!!!!!!!!!!
    (e.g. Barclays Bank - Msasa)

    Company Physical Address:!!!!!!!!!!!!!!!!!!!!!!!!


    !!!!!!!!!!!!!!!!!!!!!!!!!!!
    !!!!!!!!!!!!!!!!!!!!!!!!!!!

    Students Workplace Supervisor


    *Name: !!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
    Title/Designation:!!!!!!!!!!!!!!!!!!!!!!!!!..
    (e.g. Workshop Manager)

    Telephone Numbers:!!!!!!!!!!!!!!!!!!!!!!!!.
    Email address: !!!!!!!!!!!!!!!!!!!!!!!!!!...
    (e.g. supervisor@company.co.zw )

    Human Resources :

    !!!!!!!!!!!!!!!!!!!!!!!...

    Office Contact Tel No. !!!!!!!!!!!!!!!!!!!!!!!!


    !!!!!!!!!!!!!!!!!!!!!!!!

    Confirmation
    This is to confirm that the above student started work related-learning
    This ____ day of _____________20__ and will finish on the____ day of________________20__

    Signature: _____________________________________________ Send to : Director Work-Related Learning


    Midlands State University
    P.Bag 9055
    Gweru
    Tel:
    054-260337:
    Cell:
    0712355977
    Email:
    gumbosd@msu.ac.zw
    You can obtain WRL codes from

    http://www.msuwrl.co.zw/wrlcod
    es.php

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