Work Experience Interest Form

Work Experience Interest Form
Personal Information
Name*

First NameLast Name
Email*
example@example.com
Age*
Phone Number*
Please enter a valid phone number.
Guardian Details (if under the age of 18)

First NameLast Name
Guardian Contact Number

Area CodePhone Number
Guardian Email
example@example.com
Education Information
Name of institution*
Type of Institution*

SecondaryTAFEUniversityOther
Year Level/Course Name*
Coordinator Contact Details

First NameLast Name
Coordinator Contact Number

Area CodePhone Number
Coordinator Email
example@example.com
If other please provide details
Provide the preferred date you would like to start your placement*

DayMonthYear
Date
Provide the preferred date you would like to end your placement*

DayMonthYear
Date
Days per week*
Total hours required*
Preference for department/s you would like to gain exposure to while completing your placement*
What are your future career aspirations?
Would you require any reasonable adjustments made to the work environment?
Accompaning Documents

Resume, Cover Letter, Application
Cancelof
Student Agreement

I declare that the information I have provided is accurate and complete. Additionally, I confirm that the information has been reviewed and approved by my Parent/Guardian.
Signature*

Clear
South East Leisure (SEL) acknowledges and respects privacy of individuals. The information that is being collected, used and retained is in accordance with the Privacy Act 1988. The intended recipients of this information are SEL, its staff, insurers, and medical professionals and other statutory authorities.
Should be Empty:

Work Experience Interest Form

Personal Information

Education Information