This form is for students undertaking a vocational placement inside Australia as part of a Faculty approved subject for credit.
The student must complete this form with the assistance of the Host Organisation at least 4 weeks before the placement commences. Students cannot enrol themselves in an internship subject and will not be enrolled until all required paperwork is completed and returned.
If you have any questions regarding this form, please email firstname.lastname@example.org.
The University reserves the right to deny participation in any of the activities where your physical or medical condition may affect your safe participation.
How will you minimise the risks relating to your internship location? Please answer every question.
For each location risk, we have listed examples of control measures. Please note this is not a comprehensive list.
The University of Melbourne is committed to ensuring the safety of all students. Please consider the possible task-related hazards associated with your placement.
For each placement hazard, we have listed examples of control measures. Please note this is not a comprehensive list.
Prior to undertaking activities off campus for an internship placement I will ensure that I have:
In undertaking the placement, I understand that I have duties and responsibilities to abide by the policies and procedures of the University, Responsible Conduct of Students Procedure (MPF1061). I shall be responsible for:
In undertaking the placement I agree to the following:
I understand that all medical information shared with the University of Melbourne (the University) will be treated confidentially and is subject to the Information Privacy Act 2000 (Vic) or Health Records Act 2001 (Vic). It is recommended that I inform the University of any physical or medical conditions which may affect my comfort or safety or the safety of others during the activity or placement.
I reserve the right to decline to attend the placement or research program for any reason, or to leave the host location at any time if I feel that my personal safety or wellbeing is at risk. I also understand that the University reserves the right to exclude any student from participation in the placement or research program for reasons which the University believes are justified.
If I have any other concerns, discomfort or uncertainty relating to the placement or research program at any time, I will contact my University academic supervisor as soon as possible. I accept the above terms and conditions and understand the information I have been given.