Work Placement Application Form
  • Work Placement Application Form

    FORM-035
  • Instructions

    Work placements give learners the opportunity to apply the theory and skills gained while studying, in a professional workplace. The placements can give participants the chance to get the skills they need to transition successfully from study to work. At the same time, industry gets the opportunity to enrich student learning experiences and increase the number of work-ready graduates.

    This form must be completed prior to any placement being negotiated between the RTO and any nominated host employers and should be completed once the KARBEN Training Solutions Work Placement Handbook has been read and all terms and conditions of the placement have been considered and agreed to.

    In order to successfully complete this form you will require the following items; 

    • Head shot suitable for work place poster
    • Medicare card
    • Police check (Individual Support)
    • Working with Children's Check (Early Childhood & School Age)
  • Section A: Privacy & Confidentiality

     

    All information provided by you in this application will be kept private and confidential.  This information will only be used for the purposes of:

    • Assessing your eligibility for work experience placement
    • Allocation of placements, follow-up and post-placement support
    • Program evaluation
    • Confirmation of your qualifications and current experience

    For these purposes, your details and program report will be forwarded to KARBEN Training Solutions and the selected work experience employer contact.

  • Please tick*

  • Version 19.3.0 / 11 September 2019 | Uncontrolled when printed
    All Rights Reserved © KARBEN Training Solutions
     
    KARBEN Training Solutions | Registered Training Organisation (RTO) | National RTO ID 91167
    Email: info@kts.edu.au | Website: www.kts.edu.au | Phone: 02 4353 7188 | Postal Address: Po Box 3380 Tuggerah NSW 2259
     
  • Applicant details

  • Section B: Applicants Details

  • Qualification I am completing relevant to my placement*
  • Date of Birth
     / /
  • Address

  • Format: (00) 0000 0000.
  • Format: 0000 000 000.

  • Format: 0000 000 000.
  • Browse Files
    Cancelof

  • Version 19.3.0 / 11 September 2019 | Uncontrolled when printed
    All Rights Reserved © KARBEN Training Solutions
     
    KARBEN Training Solutions | Registered Training Organisation (RTO) | National RTO ID 91167
    Email: info@kts.edu.au | Website: www.kts.edu.au | Phone: 02 4353 7188 | Postal Address: Po Box 3380 Tuggerah NSW 2259
     
  • Eligibility

  • Section C: Eligibility Criteria

  • Are you currently employed (including self-employed) in a workplace relative to this placement?*
  • Have you obtained a ‘criminal history check’ prior to participating in the program as required by state legislation and/or local institutional policies? (Individual Support only)*
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    Cancelof
  • You cannot proceed any further if you have answered NO to this question. Please contact your trainer on 4353 7188 immediately.

  • Have you obtained a Working with Children Check volunteer or paid number or other appropriate authority as required by state/territory legislation and local institutional policies if undertaking a placement which may involve interactions with children? (Early Childhood only)*
  • Expiry date*
     / /
  • Browse Files
    Cancelof
  • If you have answered NO to this question please contact your trainer on 4353 7188 immediately to discuss further.


  • Version 19.3.0 / 11 September 2019 | Uncontrolled when printed
    All Rights Reserved © KARBEN Training Solutions
     
    KARBEN Training Solutions | Registered Training Organisation (RTO) | National RTO ID 91167
    Email: info@kts.edu.au | Website: www.kts.edu.au | Phone: 02 4353 7188 | Postal Address: Po Box 3380 Tuggerah NSW 2259
     
  • Placement preferences

  • Section D: Placement Preferences

    Please provide at least 4 preferred workplaces that you would like to complete your placement with; do not contact these employers; KARBEN Training Solutions will do this on your behalf.

    Please Note:  Placement preferences will be taken into account where possible however cannot be guaranteed and placements will be based on employer availability and suitability.

  • Rows
  • What are your preferred days / times for a placement?*
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  • Version 19.3.0 / 11 September 2019 | Uncontrolled when printed
    All Rights Reserved © KARBEN Training Solutions
     
    KARBEN Training Solutions | Registered Training Organisation (RTO) | National RTO ID 91167
    Email: info@kts.edu.au | Website: www.kts.edu.au | Phone: 02 4353 7188 | Postal Address: Po Box 3380 Tuggerah NSW 2259
     
  • Applicant's Declaration

  • Date and Time of signing*
     / /
     :
  • Are you under 18 years of age at the time of signing?*
  • Date and Time of signing*
     / /
     :

  • Version 19.3.0 / 11 September 2019 | Uncontrolled when printed
    All Rights Reserved © KARBEN Training Solutions
     
    KARBEN Training Solutions | Registered Training Organisation (RTO) | National RTO ID 91167
    Email: info@kts.edu.au | Website: www.kts.edu.au | Phone: 02 4353 7188 | Postal Address: Po Box 3380 Tuggerah NSW 2259
     
  • OFFICE USE ONLY

  • Date application received
     / /
  • Learner has completed sufficient units

  • Date work placement interview to be completed
     / /
  • Interview outcome

  • Date placement preferences contacted
     / /
  • Booking availability confirmed
  • Rows
  • Expected start date
     / /
  • Date host employer email sent
     / /
  • Status*
  •  

  • Version 19.3.0 / 11 September 2019 | Uncontrolled when printed
    All Rights Reserved © KARBEN Training Solutions
     
    KARBEN Training Solutions | Registered Training Organisation (RTO) | National RTO ID 91167
    Email: info@kts.edu.au | Website: www.kts.edu.au | Phone: 02 4353 7188 | Postal Address: Po Box 3380 Tuggerah NSW 2259
     
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