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Work Experience Placement - Host Employer Consent & Host Employer Acknowledgement

Please complete and return this form and the attached acknowledgment.

I/We agree to offer the Work Experience program outlined below:

Work Hours
Host Employer Acknowledgement From

1. Appropriately trained and experienced members of our staff will provide supervision and support to the student during the placement.

will be primarily responsible for the supervision and support of the student during the placement.

3. The Supervisor will contact the Work Experience Co-ordinator if the student is late or fails to attend for work.

Work Health and Safety

4. My organisation understands its legal responsibilities:

(a) as an employer for health and safety at our workplace(s), and will act in accordance with those responsibilities; and

(b) not to expose other people, to risks to their health and safety in our workplace(s).

5. My organisation complies with occupational health and safety laws and any other relevant codes of conduct or practice of the state in which the placement is conducted.

6. My organisation understands that a student may lack any experience in the workplace and may be unaware of health and safety risks and my organisation will take appropriate measures to meet the specific WHS needs and requirements of students whilst they are in our workplace(s).

7. My organisation will provide the student with any information, instruction and training necessary to ensure the student's health and safety in our workplace(s), including an WHS induction on the student's first day in our workplace(s).

8. My organisation will provide a safe working environment and adequate facilities for the welfare of students at our workplace; in particular we have first aid facilities, fire wardens and emergency procedures for our workplace(s). The student will be advised of these facilities and procedures during the WHS induction on the student's first day in our workplace(s).

9. My organisation has identified hazards in our workplace(s) that could harm employees and students, assessed the risks of harm to employees and students of those hazards, and taken action to control and eliminate those hazards where possible.

10. (Where applicable) My organisation will familiarise ourselves with the student's identified special needs. We understand that the School will provide a record of such needs to my organisation prior to the placement.

11. The student will not undertake any activities requiring a licence, permit or certificate of competence unless they have the relevant current licence, permit or certificate and the activity is directly related to the outcomes of the placement.

12. My organisation will supervise and instruct the student on how to use, store and maintain equipment/machinery and hazardous substances and provide protective clothing to the student where necessary.

13. If we are considering taking the student onto a building/construction site or other high risk area, we will discuss this with the Work Experience Co-ordinator in advance.

14. Should the student accompany a member of our staff or other person in a motor vehicle as part of their placement tasks, the driver of the vehicle will hold a current NSW driver's licence (as appropriate to the vehicle), and the vehicle will be currently registered, fully insured (compulsory third party and full comprehensive insurance) and roadworthy.

15. In the event that the student is injured or becomes ill at work, we will contact the Work Experience Co-ordinator [and the student's parent/guardian] as soon as practicable after being notified of the injury or illness.

Child Protection

16. My organisation is not aware of anything in the personal background of a member of staff or other person, who will have close unsupervised contact with the student during their work placement, that would legally preclude that member of staff or other person from working with children.

17. We will contact the Work Experience Co-ordinator immediately if: an allegation is made against a member of staff or other persons of child abuse or sexual misconduct against the student or we become aware of any ill treatment of the student, act of violence that occurred in the student's presence, act of violence toward the student or other occurrence that puts the student at risk.

Anti-Discrimination

18. My organisation complies with the anti-discrimination laws of the state in which the placement is conducted.

19. We understand the legal responsibilities of an employer for anti-discrimination at our workplace(s), and will act in accordance with those responsibilities.

20. We will contact the Work Experience Co-ordinator immediately if an allegation is made against a member of staff or other persons of discrimination against a student or an allegation is made of discrimination by a student.

Circumstances

21. If the circumstances of my organisation/business change prior to the student commencing the placement or during the placement, and we are no longer able to make the above acknowledgments, we will contact the Work Experience Co-ordinator to discuss the situation as soon as possible and, in the case of any change occurring prior to the student commencing the placement, before the student commences.

For any enquiries regarding this form, please contact Mrs Kristin Clulow, Careers Advisor on (02) 4927 2111.

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