Uncontrolled copy. Refer to the Department of Education and Training Policy and Procedure Register at
http://ppr.det.qld.gov.au to ensure you have the most current version of this document.
Medical information:
(List any pre-existing medical conditions that may
impact on the student’s work experience placement.
Please attach details of medications and health plans
where relevant.)
STUDENT RESPONSIBILITIES
I understand that my conditions of placement include:
• attendance at my placement for the full work experience period
• immediately notifying my school and the work experience provider if I am unable to attend or am late
• demonstrating behaviour aligned to my school’s responsible behaviour expectations and in keeping with the accepted
standards of my work experience provider
• performing my duties to the best of my ability and complying with all reasonable directions given by the work experience
provider
• following all workplace health and safety procedures in my workplace
• notifying my school and work experience provider of any incident or accident in the workplace which may involve me.
Student
signature:
Date:
/ /
PARENT CONSENT (Applicable to students under 18 years of age)
I understand that my responsibilities relating to my student’s work experience placement include:
• providing any information about medical conditions and/or medication relating to my child which may impact on the safety of
my child or the safety of others in the workplace
• organising transportation for my child to and from the work experience placement location
• notifying the school and work experience provider if my child is unable to attend or is late.
I consent to participating in work experience as stated.
Parent
signature:
Date:
/ /
WORK EXPERIENCE PROVIDER’S AGREEMENT
I enter into an arrangement for the named student to be placed with me for the purpose of work experience. Conditions of
placement include:
• understanding my responsibilities relating to health and safety under the Work Health and Safety Act 2011 (Qld)
• informing the student of particular safety requirements of this workplace including personal protective clothing/equipment
• notifying the school/work experience provider of any unexplained absences by the student
• notifying the school/work experience provider of any incident or accident involving a school student, any action undertaken
and damages to property involving the student during this placement
• providing supervision for the student at all times
• ensuring the hours worked by the student do not exceed the normal hours worked in my industry
• ensuring the student will not perform work which is prohibited by law or is unsuitable for a student placed in a work
experience environment
• understanding that the arrangement may be terminated at any time by either the school principal or myself
• ensuring the student is not paid whilst undertaking work experience
• understanding the level of liability cover provided by the Department of Education and Training.
Work Experience Provider’s
signature:
Date:
/ /
PRINCIPAL’S AGREEMENT
I enter into an arrangement for the named student to be placed for the purpose of work experience with the above named work
experience provider.
Principal’s
signature:
Date:
/ /
