Work Experience Application

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Work Experience Application

* All mandatory fields must be completed

APPLICANT DETAILS:

Full Name:

Phone:

Address:

Email: *

EMERGENCY CONTACT DETAILS:

Contact Name

Relationship

Next of Kin

Phone

Mobile

APPLICATION:

Reason for application

Referring organisation or education institution:

This may be a school, university, TAFE, College, disability support service, migrant resource service.

Referring organisation contact name and number:

Qualification being studied (if relevant)

DATES AVAILABLE:

Quarter you would like work experience to take place *

Dates you are available including days of week.

(For example 1 October 2024 to 2 December 2024 on Monday, Tuesday and Wednesday)

Brief explanation of what you need to experience and why you want to complete your placement at Liverpool City Council

Specific Area Of Interest:

ATTACHMENTS:

Current CV/Resume

Attach your current CV/Resume *

No file selected

Insurance

Here you will need to attach a Certificate of Currency, which is a document confirming that you will be covered for Public Liability under an insurance policy for the period of your work experience. If you are currently study (High School, College, University), your education institution may provide this for you. Otherwise, you will need to purchase your own insurance.

Attach your insurance as required.