Student Placement Form Full Name(required) Email Address(required) Contact Number(required) Which training institution are you from?(required) How many hours are you required to complete?(required) Is this a general or clinical placement?(required) Select one option General Clinical What dates are you required to start and complete your placement? (required) When are you available each week? (i.e. days / times)Our hours are: Monday-Wednesday, Friday (10am-3pm) And Friday night outreach program from 6pm – 12am (approximate)(required) What specific aspects of the organisation would you like to observe and participate in?(required) Street Outreach Research Admin Art Programs Fundraising Counselling Life-skills Training What are your personal aims and expectations for your placement? (e.g are there skills you would like to focus on? or particular areas you want to observe?)(required) What areas of counselling / youth work are you interested in, or looking to get into in the future? What dreams do you have for how you would like to use your training in the future? Submit Δ
Life-Gate Inc 