Student Details

Student Name

Date of Birth


Current School Year Level



Home Address

Home Phone

Mobile Phone

Email Address

Drivers Licence

Emergency Contact Details

Emergency Contact Name

Relationship To You

Phone Number

Next Of Kin

Relationship To You

Phone Number

Traineeship Details

Traineeship Name

RTO Name (if not Barringtons)

RTO Address (if not Barringtons)

Host Business Name

Host Address

Supervisors Name

Phone Number

Email Address

Bank/Tax/Superannuation Details

Name of Bank

Account Name

BSB/Account Number

Superannuation Details (Company/Membership Number)

Privacy Agreement

Privacy Agreement Barrington Group Australia Pty Ltd is required to give you information to third parties such as prospective host employers and government departments in order for us to get you employed as an apprentice or trainee. Under the privacy act (revised 2001) we require your permission for your details to be given to those people. We also require your permission to conduct reference checks.

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.