BARRINGTONS STUDENT EMPLOYMENT APPLICATION/INFORMATION FORM

• Student Name

• Document No.

• Conducted on

  Date

• Prepared by

1. STUDENT DETAILS

• 1.1 Students LEGAL Name

• 1.2. Date of Birth

• 1.3. Gender

  Male

  Female

• 1.4. Home Address

• 1.5. Home Phone

• 1.6. Mobile Phone

• 1.7. Student Email Address

• 1.8. Parent/Guardian Email Address

2. SCHOOLING

• 2.1. School

• 2.2. Current School Level

  Year 8

  Year 9

  Year 10

  Year 11

  Year 12

• 2.3. School Address

• 2.4. School Contact

3. EMERGENCY CONTACT DETAILS

• 3.1. Primary Emergency Contact Name

• 3.2. Primary Emergency Contact Number

• 3.3. Secondary Emergency Contact Name

• 3.4. Secondary Emergency Contact Number

4. TRAINEESHIP DETAILS

• 4.1. Traineeship Name

  Business 2

  Business 3

  Business Admin 3

  Hospitality 3

• 4.2. Commencement Date

  Date

• 4.3. Work Day

  Select Monday Tuesday Wednesday Thursday Friday Saturday

  • Monday
  • Tuesday
  • Wednesday
  • Thursday
  • Friday
  • Saturday

• 4.4. Host Employer Name

• 4.5. Host Employer Address

• 4.6. Supervisors Name

• 4.7. Supervisors Phone Number

• 4.8. Supervisors Email Address

5. BANK/TAX/SUPERANNUATION DETAILS

• 5.1. Name of Bank & Account Name

• 5.2. Account Number & BSB Number

• 5.3. Tax File Number

• 5.4. Superannuation Company & Membership Number

6. STUDENT I.D.

• 6.1. Type of Document & Number (eg. Student ID Card. 1234567890)

• 6.2. Student Photo I.D. if Available

  Media

• 6.3. Barringtons Representative to Verify

  Sign

7. PERSONAL INFORMATION

• 7.1. Citizenship

  Australian Citizen

  Australian Permanent Resident

  New Zealand Citizen

• 7.2. Country of Birth

• 7.3. Are You Aboriginal or Torres Straight Islander

  Aboriginal

  Torres Strait Islander

  Aboriginal & Torres Strait Islander

  No

• 7.4. Do You Speak Another Language Than English ay Home? (If yes, please state language spoken)

• 7.5. Do You Consider Yourself to Have a Disability, Impairment or Long Term Condition?

  Yes

  No

  N/A

• 7.5(a). If Yes, Please State The Nature Of Your Disability & If You Require Any Special Assistance Because Of Your Disability

• 7.6. Highest Level of School Completed

  Year 8

  Year 9

  Year 10

  Year 11

  Year 12

• 7.7. In Which Callander Year Did You Complete Your Highest Level Of Schooling?

  2011

  2012

  2013

• 7.8. Are You Still Attending Secondary School

  Yes

  No

• 7.9. Are You Currently Undertaking Any Other Study?

  Yes

  No

PRIVACY AGREEMENT (Trainee to read & sign)

• Personal information collected as a result of your enrolment will be used by Barrington Training Services for General student administration, vocational education and training administration and regulation, as well as organisational planning reporting, communication, research, evaluating, auditing and marketing. Only authorised personnel have access to this information. * Your personal information may be disclosed to Commonwealth and State Government authorities and agencies. * Your personal information may be shared with other learning providers in which you enrol of apply to. * If you are studying towards your secondary education, your personal information, attendance details, progress and results will be disclosed to your school, and/or the Department of Education, Training and Employment, Queensland Studies Authority for the purpose of the Education (General Provisions) Act 2006 and the Education (Queensland Studies Authority) Act and Regulation 2002.

• Trainee To Sign

  Sign