Work Experience Program Application

Given name

Valid given name is required.

Family name

Valid family name is required.

Valid email address is required4

Address

Valid address is required.

Are you over the age of 15?

Yes

Are you over the age of 18?

Yes

School/educational institution - Name

School/educational institution - Address

Valid address is required.

Year Level

Year 10

Year 11

Year 12

TAFE

University

Other

School/educational institution - Contact person

School/educational institution - Contact phone

Please list 3 areas of interest* or tell us what experience you hope to gain and let us match you with an area

*(view a list of our team areas)
AlburyCity teams

If you have been in contact with an AlburyCity team about this work experience, please advise of the name of the leader you have spoken with:

Why do you want to complete work experience within the area indicated above? (i.e what are you hoping to achieve as part of the placement?)

What are your preferred placement dates?

Please note: there is a minimum 4 weeks notice period on applications to allow for approvals and processing.

Monday

start time

end time

Tuesday

start time

end time

Wednesday

start time

end time

Thursday

start time

end time

Friday

start time

end time

Saturday

start time

end time

Sunday

start time

end time

Is there any further information you wish to include to support your request?

Emergency contact 1

Emergency contact 2

Please attach documentation of liability insurance that provides cover for you

Choose file

Maximum File Upload 2MB. The documentation of liability insurance can usually be obtained from your Student Guild or Student Union of your educational institution.

Please attach your Identification document

Choose file

Maximum File Upload 2MB.

I agree to abide by AlburyCity's policies, procedures and code of conduct.

I acknowledge that submission of this application does not guarantee a work experience placement.

I acknowledge that I may need to apply for a NSW Working with Children Check depending on my placement.

We are committed to protecting your privacy. We will only use the information that we collect about you lawfully (in accordance with the Privacy and Personal Information Protection Act 1998 and the Health Records and Information Privacy Act 2002).

We may collect information about you for 2 reasons: firstly, to process your request and second, to respond to any queries which you may have. We will not email you in the future unless you have given us your consent.

For more information about what data we collect, why we collect it, and what we do with it refer to our privacy policy or contact us.