Student Information

Work Experience Form (22–26 September 2025)

Work Experience Week is an exciting opportunity for students to step into the real world of work, gain hands-on experience, and explore their future career paths. It’s a chance to develop key workplace skills, build confidence, and grow employability skills.

For employers, this is a fantastic way to connect with young talent, showcase career opportunities, and strengthen ties with the local community. Hosting students not only helps inspire the next generation but also provides businesses with a fresh perspective and a chance to mentor future professionals.

Together, we can create meaningful experiences that open doors for students while offering valuable opportunities for businesses. Let’s make Work Experience Week a success!

I am thanking you on the behalf of The King’s College.

Mrs Daniela Dlugocz

VET Coordinator
VET@tkc.wa.edu.au

Student Information

Student's Name:

First Name *

Last Name *

Student's Date of Birth *

Any Medical Conditions? *

Medical Conditions

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.

Details of Medical Conditions *

Parent / Guardian Information

Parent / Guardian's Information

All students are required to participate in a ONE WEEK WORK EXPERIENCE. Student will gain valuable experience that will assist them in their future career choices. It is important to apply some thought to this process. It is the STUDENT'S RESPONSIBILITY to obtain an appropriate work experience placement for ONE WEEK.

Parent / Guardian's Name:

First Name *

Last Name *

Parent / Guardian's Email Address *

Address *

Street Address *

City *

Postcode *

Mobile Number *

Home Phone Number

Emergency Contact Information

Emergency Contact 1's Name:

First Name *

Last Name *

Emergency Contact 1's Mobile Number *

Emergency Contact 2's Name:

First Name *

Last Name *

Emergency Contact 2's Mobile Number *

Host Employer Information

Host Employer's Information

Name of Host Employer *Please enter the name of the business here

Host Employer's Address *

Street Address *

City *

Postcode *

Host Employer's Telephone *

Host Employer's Mobile Number

Host Employer's Email Address *Please ensure this email address is correct, or your host employer will not receive your form.

Type of Industry / Primary Activity at Host Employer *

Student's Work Location Address *

Details of Student's Work Location Address *

Street Address *

City *

Postcode *

Host Employer's Contact Person / Supervisor's Name:

First Name *

Last Name *

Student's Travel Arrangement

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.)

Details of Travel Arrangement *

Public Liability Insurance

The King's College is an independent AISWA affiliated school. The College's insurance coverage is placed with various Insurers via our Insurance Broker, Safeguard Insurance Solutions. The King's College provides both personal accident insurance and public liability insurance for students engaged in unpaid work placements allocated or arranged by the College.

It is a requirement of The King's College that a business accepting students on workplace learning has in place its own Public Liability insurance to an appropriate level for any one occurrence.

Safeguard Insurance Solutions will manage claims on behalf of the College, as required, in accordance with agreed arrangements.The King's College insurance policy does NOT cover accidental damage caused by the student unless negligence on the part of the student can be demonstrated.

Parent / Guardian Consent

Parent / Guardian's Consent

I, consent to my child taking part in this Work Experience Arrangement and I:

• agree that he or she will be subject to the direction and control of the Employer and nominated Supervisor(s);

• understand that all reasonable care for the health and safety of my child will be taken by the Employer and nominated Supervisor(s);

• expect my child to comply with all reasonable workplace rules and requirements governing safety and behaviour;

• understand that I am responsible for my child’s transport to and from the workplace;

• understand that I will be notified as soon as possible in the event of illness of or accident to my child, but where it is impracticable to communicate with me I authorise the person in charge at the workplace of the employer to consent to my child receiving such medical and surgical treatment as may be deemed necessary by a legally qualified medical practitioner, and administer such first-aid as is judged to be reasonably necessary;

• I attach 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;

• understand this is a compulsory school event and will ensure my child will attend work for the duration of the Work Experience Arrangement.

I have read the above-mentioned conditions and give consent to my child taking part in this Work Experience Arrangement. *

Signature *

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