Exercise sport science

To submit an application for our students to attend placement at your organisation, complete the form below.

* indicates required field

Agency name *

Email address *
This email will be used to confirm the submission of this form.

Street number and name *

Suburb *

State

Postcode *

Supervisor information

Supervisor name *

Supervisor phone number

Supervisor email *

Supervisor qualifications *

Supervisor experience *

Further information

Student position at the agency *

Student position description *
Please attach a copy of the student position description (PD). (Max. file size 5mb.) PD must include:· brief organisational overview· roles/tasks· pre-requisites and minimum requirements (i.e. IT, phone, etc)· outcomes for both the provider and student· supervisor details· resources provided (i.e. computer, desk, space, etc)· attire - contact hours

Brief description of role *

Internship location

Placement start date *
Day Month Year

Placement end date *
Day Month Year

Are the placement dates negotiable?

Contact hours *
Note: Must be a minimum of 20 hours

Number of students required *

Note: After selecting the 'Submit' button, do not close your browser window or use the back button until it is confirmed that your form has been successfully submitted.