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Work Experience, Work Placement and Internship Program Application

Program Type
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 required4
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Valid address is required.
School/Educational Institution Details
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Valid address is required.
book
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phone
email
Placement Details
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#(view a list of our team areas)
AlburyCity teams

Please Note: High risk areas require further AlburyCity approvals.

What are your preferred placement dates?

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

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Preferred placement days and times

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Do you have a whitecard or are you willing to attain privately if required?

 

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

Student Agreement Form

Please attach your Student Agreement Form*

Maximum File Upload 2MB. The Student Agreement Form can usually be obtained from your school.

Identification

Please attach your Identification document*

Maximum File Upload 2MB.

Terms and Conditions
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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.