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admin@emmanuel.wa.edu.au
(08) 9414 4000
Home
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Discover Emmanuel
From The Principal
Our Vision
Strategic Plan
History
College Performance
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Procedures
Aboriginal Education Plan
Our Community
Parish
Parents & Friends’ Association
School Advisory Council
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ECC News
Podcast: Illume
Term Dates
COVID-19
College Care
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Christian Service Learning
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Francis
Frassati
Lisieux
MacKillop
More
Romero
Siena
Teresa
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e-Learning
The Arts
Music
Performing Arts Collective
Sports
Emmanuel Royals Football Academy
Aboriginal Design Uniform Artist Story
Emmanuel Netball Academy
Emmanuel Basketball Academy
Learning Excellence
GATE
Learning Support
Bush Rangers
Extracurricula
Environmental Education
Pathways
Career Development & VET
Curriculum Handbook
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Enrol at Emmanuel
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Contact
Workplace Learning Application
Thank you for your interest in applying for Workplace Learning.
As part of this application process, you will be required to upload the following documents. Please have these ready prior to completing the form.
- Resume
- Recent School Report
- Work/Personal Reference
- Teacher References (x2)
- Worksafe Smart Move Certificate
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
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.
Industry Placement Preference
Please rank two (2) preferences for your Workplace Learning placement with number one being your most preferred industry area. Students must be able to show some knowledge and/or understanding of these industry areas at their interview.
Preference 1
(Required)
Preference 2
(Required)
Previous Work Experience or Employment
Have you had any previous work experience or employment?
(Required)
Yes
No
Please provide details
(Required)
School Subjects
(Required)
Please indicate the school subjects that you have selected for next year.
Subject 1
Subject 2
Subject 3
Subject 4
Subject 5
Subject 6
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 Workplace Learning 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)
File Upload
To complete your application, please upload the following documentation.
Resume
(Required)
Max. file size: 50 MB.
Recent School Report
(Required)
Including record of attendance
Max. file size: 50 MB.
Worksafe Smart Move Certificate
(Required)
You need to complete the Worksafe Smart Move – General Module, and then an Industry Specific Module in order to receive a Certificate. Please include a print out of the certificate you receive here. The modules can be completed online at https://smartmove.safetyline.wa.gov.au
Max. file size: 50 MB.
Declaration
Student Signature
(Required)
I certify that the above details are all true and correct. If accepted into the Workplace Learning program, I agree to abide by the decision of the Workplace Learning Coordinator as to my suitability, at any stage for the program.
Reset signature
Signature locked. Reset to sign again
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.
Reset signature
Signature locked. Reset to sign again
Date
(Required)
DD slash MM slash YYYY