Work Experience application form

Application form for the biannual week-long Work Experience Program for Secondary Students.

Please enter your contact details

Firstname *

Surname *

Email *

Mobile Enter your mobile number without spaces

Home phone Enter your mobile number without spaces

Address line 1 *

Address line 2

Postcode Enter your postcode without spaces

Suburb *

Please enter your school - college - university details

Name *

Address

Line 1

Line 2

Locality/Suburb

State

Postcode

Phone Number

Work experience Co-ordinator details

Co-ordinator name *

Co-ordinator phone number *

Co-ordinator email *

Work experience details

Please choose which program are you applying for * The Work experience at PAE program is available each June and September.

Why do you want to do Work Experience with Port Adelaide Enfield Council? *

Please attach one of the following

Workplace Learning Agreement Form

Public Liability Coverage Form Please note: Not attaching one of these forms will delay processing your request