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Employment
Store
Portals
admin@emmanuel.wa.edu.au
(08) 9414 4000
Home
Employment
Store
Portals
Discover Emmanuel
From The Principal
Our Mission
College Plans
History
College Performance
Policies
Procedures
Aboriginal Design – Story
Our Community
Parish
Community Mass
Parents & Friends
School Advisory Council
Alumni
ECC News
Publications
Podcast: Illume
Term Dates
Leading Change Through Connection
College Care
Pastoral Care and Wellbeing
Faith
Christian Service Learning
Student Leadership
Houses
Francis
Frassati
Lisieux
MacKillop
More
Romero
Siena
Teresa
Curriculum
Teaching And Learning
Real World Applications
Booklists
The Arts
The Arts Curricular
Music
Music Tuition
Drama
Dance
Visual Arts
Performing Arts Collective
Sport
Emmanuel Royals AFL/AFLW Academies
Emmanuel Aces Netball Academy
Emmanuel Knights Basketball Academy
Learning Excellence
GATE
Learning Support
Bush Rangers
Extra-Curricular
Pathways
Career Development & VET
Curriculum Handbook
Careers Portal
Enrolments
Enrol at Emmanuel
College Tours
School Fees
Scholarships and Bursaries
New Student Information
Transport
Uniform Shop
Contact
Work Experience Application
Thank you for your interest in applying for Work Experience.
If you have any questions, please see Mrs Beedie, Head of Careers and VET.
Personal Details
Student Name
(Required)
First
Middle
Last
Date of Birth
(Required)
DD slash MM slash YYYY
Student School Email
(Required)
Home Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Parent/Guardian Name
(Required)
First
Last
Parent/Guardian Phone Contact
(Required)
Parent/Guardian Email
(Required)
Emergency Contact Details
Emergency Contact 1
(Required)
Name
Mobile Number
Email
Emergency Contact 2
(Required)
Name
Mobile Number
Email
Doctor Contact Information
(Required)
Name
Surgery
Phone
Student Medicare Number
(Required)
Please include your Medicare reference number.
Previous Work Experience history or Employment
Have you had any previous work experience or employment?
(Required)
Yes
No
Please provide details
(Required)
Medical Details
This information is necessary to assist the Workplace Learning Coordinator and the Workplace Supervisor in the preparation and planning of the student’s work placement. It is a condition of a student’s participation in the program that all relevant information is included here. Students may be withdrawn from Work Experience if information is withheld. The Workplace Learning Coordinator may disclose this information to workplace supervisors.
Do you have special needs, a disability (physical or learning) or a pre-existing medical condition that could affect your performance or safety in a workplace situation?
(Required)
Yes
No
Please provide details
(Required)
In the workplace, you may need assistance with...
(Required)
Are you on prescribed medication?
(Required)
Yes
No
Please provide details. Could it affect your performance or safety in the workplace?
(Required)
Work Experience Details
Please complete the following questions to provide details of your proposed upcoming Work Experience.
Preferred date/s of Work Experience
(Required)
Name of Company
(Required)
Address of Company
(Required)
This is the address that you will be located at during Work Experience.
Street Address
Address Line 2
City
State
Post Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone Number of Company
(Required)
This is the contact number of the person you have agreed to do Work Experience with.
Email of Company
(Required)
This is the email of the person you have agreed to do Work Experience with.
Name of Employer
(Required)
This is the name of the person you have agreed to do Work Experience with.
First
Last
Declaration
Student Signature
(Required)
I certify that the above details are all true and correct. If accepted into Work Experience, I agree to abide by the decision of the Workplace Learning Coordinator as to my suitability, at any stage for the program.
Date
(Required)
DD slash MM slash YYYY
Parent/Guardian Signature
(Required)
I certify that the above details are all true and correct. I give permission for my son /daughter to be enrolled in Workplace Learning. I also give permission for their relevant details to be passed on to the Workplace Learning Coordinator and prospective workplace supervisors. I give permission for the school to provide the Workplace Learning Coordinator with a student photo.
Date
(Required)
DD slash MM slash YYYY
Email