Student Placement Request

If you would like to us to assist you find a host organisation to complete your work placement, please complete the form below




Daytime Phone / Mobile Number*


Name of Course*

Name of Training Organisation*

Number of Hours to be Completed*

Do you have a National Police Check, Blue Card or Disability Card?
Please indicate:
National Police CheckBlue CardDisability CardNone

Do you hold a current drivers license?

Please Note

Information that is provided on the form is confidential and kept for job allocation purposes only. At no stage will personal details be given to any other person or agency without seeking applicants’ consent.

Consent is granted by the applicant if and when applicant completes either in person or by phone an Expression of Interest to Volunteer or a Student Placement Request.

National Police Checks are to be completed by the relevant training organisation. If a Blue Care or Disability Card is required the host organisation will apply on the student’s behalf.

© Copyright - Flexible Living Volunteering Service 2019