Workplace Learning

Workplace Learning Detail Form

The Authority Developed Workplace Learning Program (ADWPL) enables school and industry to provide opportunities for students in Years 11 and 12 to prepare for the workplace. Through participation in a workplace learning program, students can develop and increase competence in the core skills for work, often referred to as generic, transferable, or employability skills. Participants are required to complete at least 55 hours of work placement, as well as the ADWPL logbook and skills journal.

1Student’s Details

2Parent/Guardian’s Details

3Business Organisation’s Details

4Parent/Guardian’s Consent

Student's Name(Required)

Name Surname

Birth date(Required)

Any Medical Condition(Required)

Yes

If Yes

Please provide details of any known medical condition which may affect my child, and any medication or treatment which may be relevant and give my consent to the release of any necessary health information in relation to my child by the Work Experience Coordinator to the Employer.

Name of Organisation(Required)

Business Address(Required)

Street Address Post Code

Business Telephone(Required)

Business Mobile

Employer Email Address(Required)

Type of Industry/Primary activity at workplace(Required)

Student's Work Location Address(Required)

Street Address Post Code

Workplace Contact Person/Supervisor(Required)

Student's Travel Arrangement(Required)

Detail of student’s travel arrangements to and from the workplace during the duration of the Work Experience placement: (list bus numbers, pick-up points, drop-off points, walk to work, mum’s taxi, etc.)

NOTE: PUBLIC LIABILITY INSURANCE

Student’s personal accident cover: All Work Experience students are covered under the College’s personal accident insurance cover. Students, who sustain personal injury attributable to direct or indirect, serious, or willful misconduct on their part, may not be eligible for payment under the College’s insurance arrangements.

In the event of an incident involving injury to a student, the Workplace Provider must:

Notify the parents/guardians immediately.
Notify the College as soon as possible, advising details of the incident and any witnesses or other relevant details.
Ensure the well being of the student.
Assist in removing the student from the work placement.
Ensure emergency assistance should not be more than 1 hour away.

In the event of inappropriate behavior towards students in the workplace, the student should report the incident to their parents/guardians and the College immediately.

College Emergency Contact details: Mr Ernesto Ramirez – 9314 7722.

Please attach your copy of the Work Safe Smart Move Industry Module Certificate.(Required)

Max. file size: 100 MB.

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Workplace Learning

Workplace Learning Detail Form

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Kennedy Alumni