WORK PLACEMENT APPLICATION

Use this form to notify us of your upcoming placement.

Work Placement Application

Please complete the following placement application form. This must be returned to ACAC at least 14 days prior to your placement starting.

This field is for validation purposes and should be left unchanged.
Name(Required)
Please enter in your ACAC Student Email account.
Enter the name of the workplace you are attending
Workplace Approval(Required)
Enter the name of your primary mentor at this workplace.
Mentor Approval(Required)

PLACEMENT DATES

Please indicate the expected dates and time of placement. It is ok if this varies due to workflow or other commitments. The student and workplace are expected to communicate and arrange hours to suit both parties.
DD slash MM slash YYYY
DD slash MM slash YYYY
Expected days of attendance(Required)
Please indicate which days you will be attending the workplace.
Start Time(Required)
:
Enter your shift start time (or approx time)
FinishTime(Required)
:
Enter your shift finish time (or approx time)
STUDENT DECLARATION(Required)
STUDENT DECLARATION 2(Required)
Clear Signature