Application for Internship Insurance Coverage

Application for Internship Insurance Coverage
All students doing internships are covered by insurance. The insurance coverage letter will be provided to current students/interns after the internship has been confirmed by internship hosts.

The current student/intern provides relevant information to the Employability team within five (5) working days after accepting the internship offer by e-mailing careercentre@swinburne.edu.my
APPLICANT DETAILS
Student ID*
Your 9 digits Swinburne Student ID.
Full Name*
Your Full Name as per Malaysian MyKad | International Passport.
Faculty*
Course Enrolled*
Mobile Number*
Swinburne Student E-mail*
e.g. 123456789@students.swinburne.edu.my.
INTERNSHIP HOST DETAILS
Industry Supervisor's Name*
Industry Supervisor's Position*
Name of Internship Host*
Location of Internship Host*
Internship Host Address*
Office address for internship
Internship Host Phone Number*
Internship Host E-mail*
INTERNSHIP DETAILS
Start Date*

DayMonthYear
End Date*

DayMonthYear
Faculty Supervisor's Name*
PRIVACY STATEMENT & DISCLAIMER
Privacy Statement

Swinburne University of Technology Sarawak Campus collects, uses and destroys personal data in accordance with our Privacy Collection Notice at http://www.swinburne.edu.my/privacy/.

Disclaimer

By submitting, I certify all information is true and correct to the best of my knowledge.

I understand that if the information that I submit is incorrect or incomplete that my request will not be processed.
I agree to the terms and condition stated for this application.
Should be Empty:

APPLICANT DETAILS

INTERNSHIP HOST DETAILS

INTERNSHIP DETAILS

PRIVACY STATEMENT & DISCLAIMER