QF 5402.01 Complaint Form

QF 5402.01 Complaint Form


Thank you for your interest in completing a student placement at Brisbane Youth Service (BYS).
Please complete the form and questions below and submit no later than26thMay 2017.
Please go to the Brisbane Youth Service website to find out more about what we do.
Surname: / First Name: / D.O.B.
Post Code:
Best Phone Contact:
Do you have a Working with Children / Blue Card / YES / NO / Forwarded application on / / / Blue card expiry date: / / /
Queensland driver’s licence? / YES / NO / Type of licence: / Open Provisional
Course title: / Year of study:
Tertiary institution: / Placement hours:
Expected placement start date: / Expected placement completion date:
Have you discussed this placement request with your supervisor? / YES / NO
Supervisor’s Name: / Supervisor’s Phone Number:
Supervisor’s email:

Thank you for your application. All applications are assessed based on the type of course being undertaken, the year level, the number of placement hours, the interests of the student and the requirements of Brisbane Youth Service at the time of application.

Discussed with Managers / /
Accepted for placement / Not accepted for placement
Reasons not accepted:
Student notified of outcome / / / Student’s supervisor notified of outcome / /

Your name:Click here to enter text.

Why have you chosen BYS for your placement?Click here to enter text.

What BYS program are you applying for (select from the drop down list)? Choose an item.

What is your interest in the particular program you have chosen? Click here to enter text.

What are you hoping to get out of your placement with BYS?Click here to enter text.

What strengths you will bring to BYS?Click here to enter text.

What do you think are the issues affecting vulnerable young people experiencing homelessness?Click here to enter text.

If relevant, provide information about your previous placement? (Where was it? What went well? What was challenging for you?) Click here to enter text.

Do you have any hidden talents? (singing, sports, craft, dance tutoring, etc)?Click here to enter text.

If you are a Masters student, what was your undergraduate degree?Click here to enter text.

Student Placement ApplicationPackageLast updated: April 2017

Document Ref: C4.211