Student work placement application form

Your first name: *

Your last name: *

Your e-mail address: *

Your contact number: *

Your address:

Your gender: *

What are the details of your placement (including dates required)? *

Do you have a required Room / Setting? *

What is the total number of hours and/or days you need to complete as part of your placement? *

Are you an Australian citizen or Permanent resident?

Yes

No

If no, what is your visa status?

Do you identify as Aboriginal or Torres Strait Islander?

Yes

No

Select your FIRST preferred location of placement *

Select your SECOND preferred location of placement *

Select your THIRD preferred location of placement

What is the name of your University/College/TAFE? *

What is the name of course and qualification you are currently studying? *

Have you worked at SDN previously or are you a current staff member?

Yes

No

If yes, please provide details

Upload your CV / Resume here *

Any additional comments or information?