PROF EXP 3
SECONDARY
2015
PROFESSIONAL EXPERIENCE 3 – SECONDARY
STUDENT PLACEMENT AGREEMENT FORM
LAST NAME:
FIRST NAME(S):
RESIDENTIAL ADDRESS:
STUDENT I.D.:
PHONE:
LEARNING AREA 1 (MAJOR):
LEARNING AREA 2 (MINOR):
PRESERVICE TEACHER DECLARATION AND AGREEMENT: Please read carefully.
In seeking this placement I acknowledge and agree that:
1. The Professional Experience Office will undertake all negotiations with sites in an attempt to
secure an appropriate placement for me;
2. I will not participate in any discussions with sites’ personnel in an attempt to negotiate a placement
or that may directly or indirectly influence my placement;
3. I understand that I cannot request a site which my children attend, where a close relative/friend is
employed, in which I am working in another capacity or have worked/attended as a preservice
teacher in the past, or which I attended as a school student;
4. I understand that I may be required to travel for up to 90 minutes to and from the professional
experience site; I understand that the travel distance may vary / increase depending on the
availability of placements in learning areas or region or public transport availability.
5. I understand that it is my responsibility to check myPlacement (via the student portal) to ensure
that I have provided evidence of all Compulsory Conditions for this placement. I am aware that
failure to provided evidence of any outstanding Compulsory Conditions to the Professional
Experience Office AT LEAST 12 DAYS PRIOR to the commencement of the scheduled FIRST
VISIT DAY will result in my allocated placement being CANCELLED;
6. I will not be permitted to undertake my placement without a successful Criminal History Screening
check as per University requirements (see School of Education website:
http://www.unisa.edu.au/eds/working_with_minors.asp);
7. I understand that I am required to completed the Safety and Wellbeing Online Training and provide the
Professional Experience Office with a copy of the Certificate of Attainment, if I haven’t already done
so for a previous placement.
8. I understand that it is my responsibility to present my original Criminal History Screening letter and
Safety and Wellbeing Certificate of Attainment to my allocated site on my first visit day.
9. I will respect the ‘Privacy Act of Information’ that details personal information about students, and
will maintain confidentiality;
10. I must conduct myself in a professional manner at all times whilst in the school and whilst in online
environments. In particular, preservice teachers are specifically warned not to name any school,
teacher or child in ANY SOCIAL NETWORKING online environment no matter how ‘safe’ or ‘secure’
they consider the site to be.
11. Any preferences or special requirements I may indicate on my placement application form will be
considered by the University, but will not be binding on the University or its officers as placement
allocation is dependent on places offered by external partners;
12. I understand that Placement Officers are required to take into account University staff and financial
resources, the needs of other programs, relationships between the University and sites, and
University policies, when securing placements;
I have read and understood the above and accept these conditions.
I understand that should I breach any part of this agreement, the outcome may result in the cancellation of
my placement.
SIGNED
DATE
PLEASE RETURN THIS FORM TO THE SIGNPOSTED DEPOSIT CHUTE NEXT TO
THE PROFESSIONAL EXPERIENCE OFFICE RECEPTION COUNTER
BY NO LATER THAN 5
PM FRIDAY 14TH NOVEMBER 2014