Work Experience Application Form

Work Experience Application Form

Before applying please read all of the Work Experience information on the Traineeships and Work Experience page.

Please note: we cannot guarantee any work placements. If we are unable to accommodate a student we will contact them as soon as possible. 

All applications must include your:

  • name
  • school/college/RTO/University
  • phone number and email address
  • type of placement, including details of what you want to learn and experience in your placement
  • length of placement required
  • specific dates requested
  • your availability (e.g. Monday to Friday)
  • insurance cover details
  • any additional information, such as any reasonable adjustment to the workplace you require and
  • any additional documentation required for your placement type (see above).

For more information on work experience contact the Work Experience coordinator on  4732 7777.

Your full name (required)

Your email (required)

Your phone number (required)

Institution (required)

Placement details

Areas of interest (required)

Duration in days or weeks (required)

Requested start date

Requested end date


Days of the week:

Insurance & other requirements

Placements can't be organised without appropriate insurance - speak to your school / institution about this. Depending on the type of work experience you're seeking, other requirements may also apply.

Insurance details

Please advise details including the insurance company, policy number, expiry date and amount of coverage, and be prepared to provide proof of this cover if work experience is arranged with Council.

Working with Children Check

If seeking a childcare related work experience placement, have you completed a Working with Children Check? If yes, provide Working with Children Check number:

Construction Induction Training (White Card)

If your work experience would involve routinely entering operational construction zones; (eg Civil Engineering, Parks, Development Services, Building Surveying, Town Planning, Metals & Mechanics). Do you have a White Card?

Is there any other information you'd like to tell us?

Please tick the I'm not a robot checkbox below.

By completing this form, you will be providing Council with personal information within the meaning of the Privacy and Personal Information Protection Act 1998. The purpose of Council collecting the personal information is to help Council to identify and assess your application.

We respect your privacy, and any personal information submitted to Penrith City Council will be dealt with according to the Privacy and Personal Information Protection Act (1998), Government Information Public Access Act (2009) and the Local Government Act (1993). Council will not use personal information for a purpose other than that for which it is collected.
See Access to Information.