Semester 2 2025 Student Information Form - LEC808 Professional Practice

You MUST complete this form if you wish to complete LEC808 professional practice. This form is due by close of business 15/9/25. No changes can be made thereafter, unless there are unforeseen circumstances or you need to provide your WWCC number. If there are any issues with completing this form contact the Course Director, Sabina Keppel on s.keppel@lihe.edu.au

This form will record your name, please fill your name.*

1. Student First Name*

2. Student Family Name*

3. Student Number*

4. Student Mobile Number *

5. Student Email *

6. Student Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

8. We will do our utmost to place you at an early childhood service closest to your listed home address and close to transport. However, you must be prepared to travel up to an hour on public transport to allow you to complete the unit and course requirements. Please type your name below to acknowledge acceptance for you to progress into Semester 1 2026.*

YES, I am happy to continue as a student at my current workplaceYES, but I would like to try another service as a studentNO, I would like help in finding a service for professional experience

10. If you replied YES to Question 9: List the early childhood service name and address, service centre manager/director, email address for the service centre manager/director. We will conduct our eligibility check to ensure that this service meets the requirements, so it is NOT guaranteed that you will be able to complete your professional experience there. Otherwise please write N/A below*

11. Please list your Working With Children Check (WWCC) number OR the APP number below. If you do not have one, apply at https://wwccheck.ocg.nsw.gov.au/Apply. You can then re complete this section with your WWCC number and we will be notified.

12. Please indicate below the option that best describes your current level of training in understanding anaphylaxis. I can complete the online training BEFORE the anaphylaxis practical training session organised by LIHE on 16.9.25 at: https://training.ascia.org.au/login/index.php and provide the evidence to Sabina Keppel

I can provide the certificate of completion in 2025 to Sabina Keppel.I can complete the online training BEFORE the anaphylaxis practical training session organised by LIHE on 16.9.25 at: https://training.ascia.org.au/login/index.php and provide the evidence to Sabina Keppel.I will complete anaphylaxis training by the end of Semester 1 2026.

13. Please indicate below the option that best describes your current level of training in CHCPRT025 identify and report children and young people at risk. Note: If you do wish to complete an online course, one you may wish to try is: https://accreditedshortcourses.com.au/child-protection-course-chcprt025/? gad_source=1&gad_campaignid=22380422615&gbraid=0AAAAA_KJDu6Jc6VgMdUXsCNLg HT1GN3si&gclid=CjwKCAjwqKzEBhANEiwAeQaPVQSm6_wRHz5tPrGqYbq8acQv0Tkyz8yP0Ip ROkmkcF_gGxn1Uc9YcRoCkaQQAvD_BwE

I can provide the certificate of completion of unit CHCPRT025 to Sabina KeppelI can complete CHCPRT025 child protection training this current Semester and I will provide the evidence to Sabina KeppelI will complete CHCPRT025 child protection training by the end of Semester 1 2026

YES, I understand

15. Are there any other factors that you feel may affect your professional experience that you would like to disclose? This form is confidential, but you may also write below that you would like a follow up one to one meeting confidential meeting with the Course Director if you prefer.*