SURVEYINGTASKFORCE Email Marketing -

Work Experience Application - Student Registration

First Name *

Last Name *

Email *

Phone *

Suburb (so that we can find a placement close to your home or school) *

Secondary School *

Career Advisor Name *

Career Advisor Email Address *

Current Year Level *

Dates available for work experience (your first available date should be more than 3 weeks from this application) *

Would you be willing to travel if we find a confirmed Work Experience Placement? *

Yes

No

Where did you hear about us? *

How did you hear about our Work experience program? *

Comments or questions