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Thank you for your interest in our student placement licence program. Please complete the form below and upload or email a copy of the students SU card.

One of our staff will be in contact with you very shortly to confirm the details, sort out the payment (UK £50 or ZAR1000) and organise the licence.

We appreciate the effort you are expending to help students get experience in your industry.

*Required information.

Your Details
First Name *
Last Name *
Business Name *
Address 1 *
Address 2
City *
County / State *
Postcode / Zip Code *
Country *
Email address *
Mobile / Phone *

Student Details
Student First Name *
Student Last Name *
Institution *
Course Title *
Course Start Date
Course End Date
Copy / Photo of SU Card Sent
I agree that the licence will only be used by the registered student as detailed above *
Licence Duration Required *
Date Licence Should Start *
Upload a copy of the Students SU card here
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