Industry Placement Application Form, Careers and Opportunities, La Trobe University

Student details

Student name *

Student ID *

Email address * (this must be your La Trobe student email address, e.g. j3smith@students.latrobe.edu.au)

Phone *

Course *

Campus

Student Type? *

Undergraduate
Postgraduate

Are you an international student? *

Do you have a Learning Access Plan (LAP) or other special considerations which may impact on your placement?

Are you looking to enrol in? *

LTU3IND (100 hours for Undergraduates)
LTU5IND (100 hours for Postgraduates)
Any of the 4 Industry Placement Minor subjects (LTU2PP1, LTU2PP2, LTU3PP3, LTU3PP4)

Have you checked your study plan and/or discussed with ASK La Trobe/Course Coordinator if you have the space/flexibility to undertake this elective subject (LTU3IND)?

Indicate the semester for which you are applying to complete LTU3IND and undertake the related industry placement

Semester 1
Semester 2
Summer

Have you checked your study plan and/or discussed with ASK La Trobe/Course Coordinator if you have the space/flexibility to undertake this elective subject (LTU5IND)?

Indicate the semester for which you are applying to complete LTU5IND and undertake the related industry placement

Semester 1
Semester 2
Summer

How many hours are you completing as part of the Industry Placement Minor?

1 x 400hour
1 x 200hour
1 x 100hour
Other

Indicate the term for which you are applying to complete the Industry Minor placement

Term 1
Term 2
Term 3
Term 4
Term 5
Term 6

Placement details

Name of Host Organisation: *

Address of Host Organisation:

Key Contact/Supervisor: *

Key Contact/Supervisor Phone:

Key Contact/Supervisor Email: *

Estimated Start Date:

Day Month Year

Estimated End Date:

Day Month Year

Estimated total placement hours: *

I have attached the La Trobe Self Sourced position description * Max 8mb file size

Consent

I am indicating my consent for La Trobe University to provide my CV, resume and student transcript to the below host. I understand that the data collected from my participation will be used primarily for this application, and I consent for it to be used in that manner.
I do not consent to La Trobe University to provide my CV, resume and student transcript to the above host.

Which university sourced placement are your applying for? (You can apply for more than one)

Preference 1 * (Placement title and name of organisation)

Cover Letter 1 * (Pdf file type only. Max 8mb file size)

Preference 2 (Placement title and name of organisation)

Cover Letter 2 (Pdf file type only. Max 8mb file size)

Preference 3 (Placement title and name of organisation)

Cover Letter 3 (Pdf file type only. Max 8mb file size)

Curriculum Vitae (resume) * (Pdf file type only. Max 8mb file size)

Additional information

Privacy

All information provided by applicants will be treated as confidential. At La Trobe University, we respect the privacy of your personal information. We collect personal information in your application to determine your eligibility for a scholarship, bursary or grant, and to assess your application as part of the ranking and allocation process. In accordance with privacy laws, personal information about you contained in your application will not be used for any other purpose or disclosed to any person who is not part of the La Trobe assessment and allocation process, without your permission. You may have the right to access personal information we hold about you, subject to any exceptions in relevant laws, by contacting the Scholarships Office. The La Trobe University privacy policy can be viewed at: www.latrobe.edu.au/privacy

I agree to the Declaration and Privacy above. *

I agree