Australian School-Based Apprenticeships - On-line Application

Please complete this form, ENSURE YOU HIT SUBMIT, then follow the prompts to print. Collect signatures from both your parents/guardian and your VCE/VET/VCAL co-ordinator and fax to (03) 9380 9513.

* Denotes a Mandatory Field

1. Apprenticeship Selection

I am applying for: *

	ASbA in Information Technology (15 months on-the-job experience)		ASbA in Business Administration (12 months on-the-job experience)
	ASbA in Sport & Recreation (12 months on-the-job experience)		ASbA in Children's Services (12 months on-the-job experience)

2. Student Details

First Name *

Surname *

Date of Birth *

Day	Month	Year

Address *

Suburb *

State *

Postcode *

Home Phone *

Mobile Phone *

E-mail Address *

Year Level *

Are you a Permanent Resident or Australian Citizen? *

YesNo

Parent / Guardian Name *

Contact Phone *

Parent / Guardian Signature

Date

3. School Details (to be completed by VCE/VET/VCAL Co-ordinator)

Name of School *
Name of VCE / VET / VCAL Co-ordinator
Email Address
Contact Number
Student's release day from school	MonTuesWedThursFri
Is this flexible?	YESNO
To ensure that your student is given every assistance to succeed, it is the responsibility of the school to advise us of any learning difficulties
Signature of VCE / VET / VCAL Co-ordinator

4. Further Information

Have you completed/or are you currently completing a certificate I, II or III in any area? * YESNO
If YES, please provide the following:

Completion date or anticipated date
Qualification and Level

5. Attach Resume

Please provide a copy of your resume below. To attach a document, simply click the attach button below to select a document file on your computer.

Resume

-- no attachment --

6. Sign Off

I, hereby give consent for my personal details to be disclosed to a third party as long as the information is used in direct relation to finding employment for myself.

I declare that to the best of my knowledge, that the information I have provided is true and correct. *