Work experience application formBotanic Gardens TrustPlease PRINT this form, fill it in and fax to Janelle Hatherly, Community Education Manager 02 9251 4403. Date:_____/_____/_____ Personal details of work experience applicantName: ........................................................................................................ Title (Dr, Mr, Mrs, Ms etc.): ....................................................................... Contact details: ......................................................................................... Age Group (please circle): 18-25 • 26-35 • 36-49 • 50-65 • Over 65 • Course of Study undertaken: ................................................................... Educational Institution: .............................................................................. Insurance Cover: ...................................................................................... Nature of work experience request.................................................................................................................... .................................................................................................................... Skills and competencies expected to be obtained during the work placement.................................................................................................................... .................................................................................................................... Duration and hours of placement.................................................................................................................... .................................................................................................................... Placement areaHorticulture (give details): .................................................................................................................... Science (give details): .................................................................................................................... Education (give details): .................................................................................................................... Marketing &Communication (give details): .................................................................................................................... Other (give details): .................................................................................................................... Additional relevant information.................................................................................................................... .................................................................................................................... Signature of applicant.................................................................................................................... Note that this application does not automatically confirm a placement. |
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