Work Experience Program Application | AlburyCity
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Work Experience Program Application

Contact Details
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Valid given name is required.
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Valid family name is required.
phone
Valid phone number is required.
phone
email
Valid email address is required.
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Valid address is required.
School/Educational Institution Details
school
location_on
Valid address is required.
book
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phone
email
Placement Details

What are your preferred placement dates?

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event

Preferred placement days and times

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access_time
access_time
access_time
access_time
access_time
access_time
access_time
access_time
access_time
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access_time
access_time
access_time
Emergency Contacts

Emergency contact 1

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phone
Valid phone number is required.

Emergency contact 2

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phone
Valid phone number is required.
Liability Insurance

Please attach documentation of liability insurance that provides cover for you

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

Terms and Conditions

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.