CACHE Level 3
Early Years Educator
Placement Supervision Agreement
Learner No. Learner Name
In order to complete this course you will need access to the following age ranges which may
require more than one placement or setting.
Age Range Hours
0-1 year 11 months 25
2-2 years 11 months 133
3-5 years 192
Please complete the information for each of your placements. You may not need to
complete all of these this will depend on how many settings you are attending to complete
the required hours of the course across the age ranges.
Placement No 1:
Date of placement commencement: D D / M M / Y Y
Organisation:
Address/email address
Age Range Which days of the week
This form indicates that you have been informed of the placement supervision requirements
of the course, and that you consent to provide work experience support and supervision for
the above-named learner. (Placement supervisors are required to supply their certificates
and attach an up-to-date CV with this form). We cannot begin to assess work until this is
in place.
Mentor (please print name) and
EYE Placement Agreement Feb 2016 Page 1 of 4
provide a handwritten signature
Job description (to be written in
the box or recorded as a voice
recording
Placement No 2:
Date of placement commencement: D D / M M / Y Y
Organisation:
Address:
Age Range Which days of the week
EYE Placement Agreement Feb 2016 Page 2 of 4
Mentor (please print name) and
provide a handwritten signature
Job description (to be written in
the box or recorded as a voice
recording
Placement No 3:
Date of placement commencement: D D / M M / Y Y
Organisation:
Address:
Age Range Which days of the week
EYE Placement Agreement Feb 2016 Page 3 of 4
Mentor (please print name) and
provide a handwritten signature
Job description (to be written in
the box or recorded as a voice
recording
Upon completion, upload to the portfolio system via the ‘optional evidence upload’ button,
or send to: Stonebridge Associated Colleges, Stonebridge House, Ocean View Road Bude,
Cornwall, EX23 8ST, United Kingdom
EYE Placement Agreement Feb 2016 Page 4 of 4