For Student On Attachment Name* First Name Surname ID NumberDOBProfessionGenderMaleFemalePhysical AddressPermanent AddressQualificationsName Of University / CollegeDuration of Internship Required (Months)Program of StudyYear of Enrolment Date Format: MM slash DD slash YYYY Preferred Location in Order of Preference (List)Do you have accommodation in the preferred location?YesNoDuration of Internship Required (Months)Last Date of Placement Date Format: MM slash DD slash YYYY Have you been convicted of any crime, other than traffic offences & maintenance related?YesNoGive Date of conviction & offence Date Format: MM slash DD slash YYYY Key to AvailabilitySTP (1 week-3 months)-Short Term Placements MTP (3-12 months)-Medium Term Placements ERS (Hours/Days as required)-Emergence & Relief Services DRM (Hours/Days, as required)- Domestic Repair and Maintenance Works AHA (once off assignments-hours/days)-Ad Hoc Assignments Total $0.00
