Student Placement Enquiry (Training Organisation)

Welcome and thank you for considering St Basil’s Homes (SA) as a potential placement host for your training organisation.

Please complete the following enquiry form and we will review your details and get back to you.

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Contact Name*

Contact Phone Number*

Contact Email Address*

Education Institution*

ABN*

RTO Code*

Course Name*

Course Code*

Do you have a current active Public Liability Insurance policy?*

Placement Start Date*

Placement End Date

Number of students for placement

Preferred Location(s) of placement*

Aegean Village

Croydon Park

St Peters

Which site/s would you like prefer to host your student placements.

Required hours to complete placement (eg. 120hrs, 160hrs etc.)*

Are students trained in the following area's prior to commencing placements?*

Manual Handling

Infection Control Practices

Aged Care Quality Standards

The Serious Incident Response Scheme

Please select the most appropriate option/s.

Learning objectives required from the placement*

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