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Year 12 Work Experience Monday 13th - Friday 17th July 2020
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* Indicates required question
Student Full Name
*
Your answer
Gender
*
Choose
Male
Female
Name of company/organisation of work experience
*
Your answer
Address of company/organisation where work experience will be held
*
Your answer
Name of Mentor/Manager
*
Your answer
Telephone Number
*
Your answer
Email Address
*
Your answer
Function or activity of company/organisation
*
Arts, Entertainment and recreation
Charity
Finance
Healthcare
Hospitality inc. Restaurants
Law
Media, Design and PR
Retail
Properties
Education
Other
Please enter a brief description of the duties/activities you will be involved with
*
Your answer
Company Insurance Liability Number
*
Your answer
Company Insurance Expiry Date
*
MM
/
DD
/
YYYY
Company Insurance Provider
*
Your answer
Have you confirmed permission of the employer to have a period of work experience during the above dates?
*
Yes
No
Required
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