CRICOS Provider Code: 00117J
LA4041 Legal Placement (self-sourced)
College of Business, Law & Governance Work Integrated Learning (WIL) program
Student Name Student #
Email Campus
Emergency Contact Phone
Relationship to you
Host Organisation ABN
Street Address
Supervisor Name Phone
Supervisor Job Title Email
Timing Are you employed by this organisation? Yes No
Workplace Supervisor to provide an outline of job description/tasks to be undertaken
Additional information or requirements
CRICOS Provider Code: 00117J
James Cook University (JCU) offers a Work Integrated Learning (WIL) program which is designed as a
pathway for students to acquire industry experience and enhance graduate employability.
In order to proceed with the offer of a student placement, please review the conditions of
placement outlined below and acknowledge acceptance with your signature:
the workplace complies with the Work Health and Safety Act 2011 (Qld) (or equivalent)
the workplace will provide a minimum 12 days of relevant and productive work to the student
the workplace will provide the student with an induction, suitable workspace and access to
required resources
the nominated workplace supervisor will provide adequate supervision to the student for the
duration of the placement
the nominated workplace supervisor will engage in an informal meeting with the student prior to
the student commencing their placement to discuss the role and learning outcomes
JCU and the placement provider firm will enter into a Student Placement Agreement. Sample can
be obtained prior by emailing
The nominated workplace supervisor agrees to provide required feedback to JCU on the students
performance, and agrees to submit required reporting within one week of it being requested.
Signed by Workplace Supervisor Signed by Student
Full name Full name
Date Date
Submit completed form (inclusive of unofficial academic transcript) to