Workplace Learning- Placement Preference Form

Please indicate your situation(Required)

Advising my placement preferences for year 11 semester 1 or 2

I didn’t do workplace learning in year 11 but want to do it in year 12

Advising my preferences for a work placement that is required as part of my external Course with FEC or TAFE etc.

Special consideration for Work experience in Year 10

Placement Year(Required)

What is the general Industry you want to work in?(Required)

Applicant Information

What year are you currently in?(Required)

Year 10

Year 11

Year 12

Your Name(Required)

First Last

Mobile Number of Student(Required)

Suburbs you can easily get transport to for work placements. Eg Cockburn and Henderson(Required)

How will you be getting to your placement? Eg. Bus, lift from parents(Required)

Placement Preference Information Form

Do you have a contact you have spoken to about workplace learning ?(Required)

Tick YES if you have someone you know who is willing to take you on for workplace learning. If you need us to find a placement for you, tick NO.

Yes

Name of the Business(Required)

Contact Person Name(Required)

First Last

What job will you be doing?(Required)

Address(Required)

Street Address Suburb Post Code

Phone(Required)

Email(Required)

Preference 1(Required)

Please list some examples of workplaces that you have researched or would like to work in. eg. JB Hifi, Jandakot Smash Repairs. Please them in order of preference. Note, you do not have to contact the employer, but do need to look up and record their contact details. If you don’t have the contact name, just indicate that in the box.

Company

Job you'd like to do

Address

Contact Name

Contact Number

How did you get this contact? (Own contact, provided by the school or other)

Preference 2(Required)

Please list the second preference company and job you would like to do.

Company

Job you'd like to do

Address

Contact Name

Contact Number

How did you get this contact? (Own contact, provided by the school or other)

Preference 3(Required)

Please list the third preference company and job you would like to do.

Company

Job you'd like to do

Address

Contact Name

Contact Number

How did you get this contact? (Own contact, provided by the school or other)

Preference 4(Required)

Please list the fourth preference company and job you would like to do.

Company

Job you'd like to do

Address

Contact Name

Contact Number

How did you get this contact? (Own contact, provided by the school or other)

Preference 5 (optional)

Please list the company and job you would like to do.

Company

Job you'd like to do

Address

Contact Name

Contact Number

How did you get this contact? (Own contact, provided by the school or other)

Preference 6 (optional)

Please list the company and job you would like to do.

Company

Job you'd like to do

Address

Contact Name

Contact Number

How did you get this contact? (Own contact, provided by the school or other)

Please upload a copy of your resume(Required)

Max. file size: 512 MB.

The Workplace Learning Coordinator needs some details about you, your career aspirations and your previous work experience (if any) If you don’t have a resume, you can create one by clicking logging in to Career Tools. https://www.emmanuelcareers.com.au/login Click on “Portfolio” and then use the resume template.

Declaration

I UNDERSTAND:

1. All sections on the form must be completed in full.

2. Preferences must be realistic. I should have an idea of the job role and the tasks I am likely to be undertaking.

3. Once a placement is organised there should be no changes and I am committed to finish the placement dates.

4. If I lose my placement as a result of poor attendance, lack of interest/enthusiasm, bad attitude, poor performance etc. I may be required to find my own alternative placement.

5. I must act in an exemplary manner at all times in the workplace and can be withdrawn for misconduct. I represent Workplace Learning, my school and myself.

6. I must inform the HOST EMPLOYER, WORKPLACE LEARNING COORDINATOR and MRS BYRNES if I am going to be absent from the workplace, giving as much notice as possible.

7. I must advise the Workplace Learning Coordinator Mrs Carson and Mrs Byrnes of any issues associated with the workplace.

8. Workplacement commitments receive priority over all after-school activities.

9. I may need to travel a distance to my work placement which may include using public transport.

10. I may make up absent/extra days by negotiating with the workplace supervisor and need to communicate these with the Workplace Learning Coordinator and Mrs Byrnes.

11. I am responsible for bringing my logbook to the workplace each day and for completing all tasks to meet ADWPL requirements including showing your logbook to Mrs Byrnes each week (unless you are doing a block placement which will require you to show your book to Mrs Byrnes when you return to school).

Student Signature(Required)

Date(Required)

Parent/Guardian Signature(Required)

Date(Required)

Parent/Guardian Name(Required)

First Last