SENIOR COLLEGE STUDENT WORK EXPERIENCE ARRANGEMENT FORM

  1. STUDENT DETAILS

SURNAME GIVEN NAME BIRTH DATE

TEACHER-IN-CHARGE OF WORK EXPERIENCE

In case of Emergency, Employer should contact Student's Parent/Guardian

NAME: (PARENT/GUARDIAN)

ADDRESS:

EMERGENCY PHONE No. Home/Work

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2.THE WORK OBSERVATION ARRANGEMENT

BUSINESS NAME: PHONE NO: ______EMAIL: ______

BUSINESS ADDRESS:

POSTAL ADDRESS: ______

NAME OF PERSON STUDENT SHOULD CONTACT:

HOURS OF WORK: DURATION OF WORK:

FIRST DATE: 25th September 2017FINAL DATE: 29th September 2017

PROPOSED TYPE OF WORK OBSERVATION:

I agree to take the student for work experience, as long as he or she is performing satisfactorily, and that I will consult the Senior College if I consider it necessary to terminate the arrangement before the specified time. I will notify the Senior College whenever the student is absent, is ill, or is injured in the course of his or her employment. I understand the student is insured by the Senior College.

SUPERVISOR’S SIGNATURE: ______DATE:______

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3.PRINCIPAL

I, the Principal of The Essington International Senior College, Charles Darwin University, grant permission for ______

(Name of Student)

who is a student of the Senior College, to be employed for the purpose of work experience by ______

(Name of Employer)

PRINCIPAL'S SIGNATURE DATE:

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4.PARENT'S PERMISSION FORM

I agree to my child taking part in the Work

(Name of Student)

Observation Program. I agree that he or she will be subject to the direction and control of the persons conducting the work observation program, and I expect my child to obey all reasonable rules governing safety and behaviour. I understand that my child is covered by insurance. In the event of illness or accident to my child, I will be notified as soon as possible, but I authorise the person in charge, where it is impracticable to communicate with me, to consent to my child receiving such medical and surgical treatment (including the administration of an anaesthetic) as may be deemed necessary by a legally qualified medical practitioner. I understand that all reasonable care for the safety and health of my child will be taken by the person in charge of the work observation program.

PARENT'S SIGNATURE: DATE:

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5.STUDENT AGREEMENT FORM

I, will attend at my place of employment every day at the agreed time and

(Name of Student)

I will inform both my employer and the Senior College as soon as possible if I am unable to report to work. My dress and my appearance will be acceptable to my employer and I will perform my work to the best of my ability. I will promptly inform my employer of any accident or injury that may occur.

STUDENT'S SIGNATURE: DATE: