Work Experience Application - Student Registration

First Name *

Last Name *

Email *

Phone Number *

Address *

City *

State *

Postcode *

Secondary School *

Career Advisor Name *

Career Advisor email Address *

Current Year Level *

Dates available for work experience *

Please specify the dates you are available for work experience. The first available date should be more than 3 weeks from this application.

White Card compliance *

I will be 15 years and over at the time of placement *

Yes No

Where did you hear about us?

Comments or Questions *

Please tell us the reasons why you are interested in surveying and doing work experience with a surveying firm.