Online Form - Work Experience Application

Thank you for considering the Shire of Wyndham East Kimberley in your endeavour to obtain Work Experience. Please complete this form, collate your supporting documents and provide to the Shire.

Save Your Progress

You have the ability to save this form and complete it at a later date. An email will be generated and sent to the specified address.

Note: Incomplete forms are kept for a period of 2 day(s), after this time the system will automatically delete your response.

Personal Details

Postal Address
Residential Address

Placement Details

Preferred work experience days *

Additional Details

To assist in assessing opportunities for your placement in the appropriate type of work, please indicate whether you have a disability or injury likely to affect your ability to perform tasks, which could reoccur or be aggravated by the type of work experience that you are applying for *

Supporting Documentation

Insurance Document

You must provide a copy of your school, university, institution or organisation’s insurance Certificate of Currency with your application – this provides SWEK with proof of insurance coverage during placement.
Maximum size of ALL attachments is 976.56 MB

Confirmation of Approval/ Support

Your school, university, institution or organisation will need to provide written confirmation of their support/approval for your application and confirm that it relates to your current educational/career pursuits.
Note - if you are aged between 15 -17 you will need to provide written confirmation from your parent/guardian.
Maximum size of ALL attachments is 976.56 MB
Maximum size of ALL attachments is 976.56 MB


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