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Application form Employment

VIEWS: 6 PAGES: 18

									                               Version 5.0 February 2012




DEPARTMENTAL OFFICE USE ONLY
Applicant Organisation:
Proposed Project Name:
Date Received:
Program & APP ID:
Section 1 Grant applicant details
1.1   Legal name of organisation

1.2   Trading name of organisation
      (if different from above)

1.3   Have your contact details changed since you             Yes       No
      last applied?                                           (if yes, please complete the changes below. If no, proceed to Section 2)
1.4   Authorised contact details: Title                       Mr        Mrs     Ms        Miss      Doctor
      First name
      Last Name
      Position
1.5   Postal address                                          Address
      (all correspondence will be directed to this address)
                                                              Town /Suburb
                                                              Postcode
1.6   Street address                                          Address
      (if different from above)
                                                              Town/suburb
                                                              Postcode
1.7   Organisation’s contact details                          Phone
                                                              Facsimile
                                                              Email
1.8   Incorporation type

      Incorporation number



Section 2 Financial management details
      Organisation Australian Business Number
2.1
      (ABN)


2.2   Is this application being submitted by a lead           Yes        No
      organisation on behalf of other organisations           (if yes, please detail the Name and ABN of each participating organisation
      i.e. a cluster type arrangement?                        below)


Name:e                                                        ABN:e


Name:e                                                        ABN:e


Name:e                                                        ABN:e




                                                                        2
Section 3 Project overview
3.1   Which program are you applying for grant
                                                                       Community Employment and Infrastructure Program
      funding from?
      (single application per program)                                 Community Literacy Program
                                                                       Get Set for Work Program
                                                                       Participate in Prosperity (PiP) Program
                                                                       DEEDI strategic/industry intervention e.g. Disaster Recovery Plan,
                                                                       Industry Alliance Project
                                                                       Productivity Places Program (PPP) – funding ceases 30 June 2012
                                                                       Training Places for Single and Teenage Parents

3.2   Is this application the result of an annual               Yes     No
      performance review with DEEDI?
      (Organisations on long term contracts are subject to
      annual performance reviews and must update any
      organisational or project details that have changed
      from their initial application)

3.3   Project name
      (use an overarching project name if delivering
      multiple projects)

3.4   Project Coordinator’s name                                                                 Project Coordinator’s
      (if different from authorised contact)                                                     telephone number
3.5   Organisation’s Media Contact                                                               Media Contact’s
      (if different from authorised contact)                                                     telephone number
3.6   Who will be assisted?                                            eligible single and teenage parents under Training Places for Single
      (More than one box may be checked however, try                   and Teenage Parents
      and restrict your selection to the primary group that
                                                                       job seekers eligible under the Productivity Places Program
      you will be recruiting. Please select long-term
      unemployed only as a general rule unless you are                 long-term unemployed people
      specifically targeting one of these key population               people who are employed 25 hours per week or less and who are
      groups)                                                          unable to secure a full-time job because they lack the necessary
                                                                       skills (underemployed)*
      For further information regarding eligibility criteria,
                                                                       low skilled workers who are vulnerable in the workforce due to
      refer to the relevant Memorandum of Agreement
      which can be viewed at:                                          technological change or industry restructure*
      www.employment.qld.gov.au/providers/toolkit                      people with a disability
                                                                       parents and carers
                                                                       Aboriginal and Torres Strait Islander peoples
                                                                       Australian South Sea Islanders
                                                                       older jobseekers aged 45 years and over
                                                                       young people aged 15-17 years
                                                                       young people aged 18-24 years
                                                                       people from culturally and linguistically diverse communities,
                                                                       including refugees and recently arrived migrants
                                                                       people living in rural and remote areas
                                                                       ex-offenders
                                                                       people with low levels of literacy and numeracy who cannot
                                                                       effectively participate in the labour market
                                                                *unable to participate in the Skilling Queenslanders for Work Productivity
                                                                  Places Program – job seeker training places only




                                                                        3
3.7    Total number of participants to be assisted
       (participants must only be counted once even if
       offering multiple assistance to individual participants)

3.8    Detail the assistance tools or services to be delivered, the number of places for each assistance tool and the delivery location.

Assistance Tool                                                   No. Places            Delivery Location/s – please include street address and
                                                                                        postcode for each delivery location

       job preparation assistance (including non-
       accredited training and work experience)
       accredited vocational education and training
       tutor mentoring and coordination (for Community
       Literacy Program applicants only)

       paid work placements
       Specialist Coordinator e.g. Participate in                         N/A
       Prosperity, DEEDI strategic/industry
       intervention
3.9    What are the proposed outcomes?                            Outcome                                                  %              Number
                                                                  Employment
                                                                  Further education and training
                                                                  Return to school
                                                                  Full Qualification
3.10   Will you be offering contribution towards                  Yes      No
       transport and childcare costs for eligible
       parents and carers?                                        If yes, please specify the assistance




3.11   Please provide a summary of the project
       (What is the project about? What will the project achieve? Specify the target group and what services are being delivered. Restrict your answer
       to a few paragraphs)




3.12   If applicable, indicate the industry area your project best aligns to e.g. if delivering accredited training in aged care select
       Community Services or for horticulture select Primary Industry
       Arts & Entertainment                                  Furnishing                                         Process Manufacturing
       Automotive                                            General Education & Training                       Retail
       Business                                              Government                                         Sports & Recreation
       Communications                                        Health                                             Textile, Clothing & Footwear
       Community Services                                    Hospitality                                        Tourism
       Construction                                          Laboratory Operations                              Transport & Distribution
       Engineering                                           Mining                                             Utilities
       Food Processing                                       Primary Industry




                                                                           4
3.13   Project commencement date                                       /         /
3.14   Project completion date                                         /         /
Indicate project stages and activities in the table in Attachment A – Project Plan


Section 4 Project Budget
4.1    Please use the Skilling Queenslanders for Work budget worksheets to calculate expenditure. These work sheets must
       accompany this application form.
Budget summary
(excluding GST)                                                TOTAL GRANT SOUGHT                               $



                                                               TOTAL OTHER CONTRIBUTIONS                        $



                                                               TOTAL COST OF PROJECT                            $


4.2    Please attach letters from organisations confirming the estimated dollar amount of any cash/in-kind contributions.
       You are asked to provide details on this information in the budget worksheets on the Budget Proposal Summary page.


4.3    Have you applied for, or received, funding
       from other state or federal funding programs          Yes       No
       for this project or components of this project?       If yes, please provide details of sources and for what services and indicate
       (this includes Job Services Australia or any other
       employment related services funding)
                                                             what steps you will take to ensure the project will not duplicate, or substitute
                                                             for, these services




Section 5 Project details
The following questions relate directly to the assessment criteria detailed in the program funding guidelines. Please indicate how your
project addresses the following assessment criteria:

Capacity to manage the project
       What experience and expertise do you, and any other organisations involved in the delivery of the project, have in the delivery
5.1    of similar projects and management of government grant funds?
       (include experience in delivering employment and training projects in a community setting and to specific target groups)

       Please attach income and expenditure statements for the last 2 years for the organisation that will manage the grant
       funds.




                                                                           5
5.2    Who will be involved in the delivery of the project and what relevant qualifications, skills and experience do they possess?
       Please attach a resume or brief background information for each person involved in the delivery of the project .
       (Note the requirement for staff delivering services to young people under 18 years of age must hold a positive suitability notice (blue card)
       issued by the Commission for Children and Young People and Child Guardian: www.bluecard.qld.gov.au)




5.3    How will participants from the identified target group(s) be recruited for the project?
       (include any promotional or marketing strategies) NOTE: Under Training Places for Single and Teenage Parents eligible participants will
       be directly referred by JSA/DES providers




Servicing community needs
5.4    What need in the community will the project address? Is there any impact on the wider community?
       (Does the project meet a relevant local need? Can the project demonstrate a commitment to increase workforce participation?)




5.5    Outline the support that the project has in the local community. How does the project link with other local initiatives or support
       other services within the community?
       (Does this project complement, rather than duplicate, other local initiatives?)
       Please attach letters of support from community representatives, local employers, industry, Members of Parliament,
       service providers etc




5.6    How will the project alleviate skill shortages and meet local labour market needs?
       (identify any links to local industry/employers, how industry skills needs will be met/addressed and any work readiness activities for skills in
       demand)




Strategies to assist participants
5.7    What processes and strategies will be used to identify and address the barriers of individual participants?
       (detail any other programs and support services that will be available to assist participants)




5.8    What skills will participants develop as a result of the project?
       (detail skills gained through both non-accredited training and accredited training)




Strategies to achieve outcomes
5.9    How will you measure the success of your project?
       (describe the measurable outcomes the project hopes to achieve and how these will be evaluated and include any qualitative outcomes)




5.10   Following the completion of the project, outline the support that will be provided to participants during the post-participation
       support phase (up to 6 months)




                                                                           6
Section 6 Job preparation assistance (only complete this section if included in the project)
6.1   Name of organisation providing job preparation
      assistance (leave blank if the same as applicant organisation)


6.2   Please detail the job preparation services to be
      provided to participants
      (including all non-accredited training and work experience)


6.3   If there are to be rolling starts or intakes, indicate when           Intake              No Participants     Start Date/s
      these will be and how many participants in each intake


6.4   Does the job preparation assistance include work                      Yes      No
      experience?
      (work experience placements must be arranged in accordance
      with the provisions of the Education (Work Experience) Act
      1996)

Section 7 Accredited vocational education and training (only complete this section if included in the
project. For accredited training under Work Skills Traineeships refer to Section 9)

7.1   Name of registered training organisation providing
      accredited vocational education and training


7.2   Are you a registered training organisation?                           Yes      No

7.3   Have you obtained 3 quotes for training delivery using                Yes      No
      the Training Quotation proforma?
                                                                            If no, detail reason for exemption.

      Training Quotation forms must be attached.

7.4   What training is proposed to be delivered and explain
      how the training is appropriate for the target group?
      (provide justification for certificate level and method of delivery
      – aligns with the learning needs of target group)
      For PPP you must specify the full eligible qualification/s to
      be delivered in accordance with the Priority Occupations
      and Qualifications List

7.5   Does the training include vocational placement?                       Yes      No
      (Department of Education and Training administers the
      Training and Employment Recognition Council which is                  If yes, attach a copy of the letter of approval from the Training and
      responsible for the registration and regulation of vocational         Employment Recognition Council or an application for an approved
      placements)                                                           training scheme as appropriate.

7.6   What is the total number of nominated Annual Hours
      Curriculum (AHCs) of accredited training to be
      delivered?
      (you are asked to provide specific details on qualification and
      competency codes and nominal hours, if known, in the budget
      worksheets)




                                                                            7
7.7    If there are to be rolling starts or intakes, indicate when        Intake              No Participants          Start Date/s
       these will be and how many participants in each intake


7.8    Do you intend on using the Course in Adult Literacy and            Yes       No
       Numeracy 30719QLD?
       (relevant to Community Literacy Program applicants only)

       If yes, do you have current permission from the                    Yes       No
       Course owner, the Department of Employment,
                                                                          Please attach a copy of the approval letter
       Economic Development and Innovation (DEEDI) to
       deliver the Course?
                                                                          Contact DEEDI on 1300 369 925 to undertake a Suitability Survey. The
                                                                          survey is designed to enable DEEDI to assess how capable an organisation
                                                                          is to deliver the curriculum appropriately.

7.9    Have you obtained VET Revenue General from TAFE                    Yes       No
       for the delivery of accredited training?


7.10   What reporting and data collection method will be                        AVETMISS compliant software
       used?
                                                                                Manual submission of VET enrolment forms

                                                                                TAFE information student administration system (ISAS)


Section 8 Tutor mentoring and tutor coordination (Community Literacy applicants only)
8.1    Name of organisation who will provide tutor mentoring
       and tutor coordination
       (leave blank if the same as applicant organisation)


8.2    Provide details of any volunteer support activities to be
       provided
       (includes tutor mentoring of volunteer tutors and tutor
       coordination of volunteer tutors and participants)

Section 9 Work placements (only complete this section if included in the project)
9.1    Legal name of organisation providing work placements

       Note: The organisation (as the employer) must provide the
       name of the legal entity not a trading name, business
       name or name of a trust – refer to instruction booklet.

9.2    Number of work placement projects to be offered, where they are to be delivered, length in weeks and proposed start and
       completion dates for each project (the project location will be where the participants are working)

Number     Delivery Location/s – please include street address            Length     Qualification – detail relevant     Start        Completion
           and postcode for each delivery location                        (weeks)    Work Skills Traineeship             Date         Date




9.3    Describe the community or public benefit
       (If delivering multiple projects, describe the community benefit
       for each project)




                                                                          8
9.4    Detail the work activities to be undertaken
       (If delivering multiple projects, describe the different vocational
       areas for each project)



9.5    Provide details of alternative work activities if required
       due to adverse weather conditions for outdoor projects

9.6    Select the Work Skills Traineeship to be completed by                       Work Skills Traineeship (Business)
       the work placement participants
       Note: Attachment B must also be completed –                                 Work Skills Traineeship (Conservation & Land Management)
       details the accredited competencies from the
                                                                                   Work Skills Traineeship (Construction)
       corresponding Certificate I qualification.

9.7    Provide details of any additional or alternative training
       to be delivered
       (attach a quote for the delivery of training and include delivery
       method e.g. will it be integrated or off-the-job and how many
       days per week)

9.8    Name of the Modern Award that participants will be                    Modern Award:
       employed under
9.9    Will the participants be employed on a full-time or part-
       time basis?
9.10   What capacity does your organisation have to provide
       the facilities, range of work, supervision and training
       required for the Work Skills Traineeships
       (refer to the relevant competencies identified in Attachment B)
       Note: Excess supervision ratio of 1:15 has been
       approved by DET for Work Skills Traineeships
9.11   Name of work placement supervisor – designated
       qualified person directly responsible for supervising the
       Work Skills trainees
       Qualifications / skills / experience
       (refer to Instruction Booklet for definition of a qualified person)

9.12   Name of Supervising Registered Training Organisation
       (SRTO) who will be engaged to assess/provide
       accredited vocational education and training


9.13   Have you obtained VET Revenue General from TAFE                       Yes      No
       for the delivery of accredited training?



9.14   What reporting and data collection method will be                           AVETMISS compliant software
       used?
                                                                                   Manual submission of VET enrolment forms

                                                                                   TAFE information student administration system (ISAS)


9.15   Name of Australian Apprenticeship Centre (AAC)




                                                                             9
9.16   Are you using a host employer work placement model?             Yes       No
       (refer to Instruction Booklet for further details)
                                                                       If yes, letters of support from each host employer will need to be
       NOTE: This type of model would be the exception
                                                                       attached – template letter to use is supplied at Attachment C
       rather than the rule

Section 10 Other strategic interventions                                    (Participate in Prosperity and DEEDI Strategic/Industry
Interventions only)
10.1   Briefly outline why the project is urgently required.
       (this could be in direct response to natural and economic
       disasters affecting local communities)

10.2   Provide details of the major role and functions to be
       carried out by the Specialist Coordinator

10.3   How is the project responding to gaps in current
       services?
       (include details on the provision of social services or the
       referral to appropriate service providers)
Section 11 Multicultural Employment Workshops                                         (participation in the workshops is not restricted –
there is no eligibility criteria)
11.1   Name of organisation who will provide Multicultural
       Employment Workshops
       (leave blank if the same as applicant organisation)

11.2   Provide details of the proposed workshop program
       including:

           demonstrated need
           workshop focus
           other organisations involved in the delivery
           localities
           number of attendees
           profile of attendees e.g. ethnicity, skill levels
           dates (may be approximate)

       Enter budget costs for delivering workshops in the Job
       Preparation Worksheet of the Budget Tool.

       Funding can cover trainer costs, development and evaluation
       of workshops and actual delivery costs (administration costs,
       venue hire and catering).


11.3   Workshop Content - please indicate which of the following topics will be covered in the proposed workshop program


        Australian work culture                                                 The Queensland labour market
        Accessing public sector employment                                      Accessing private sector employment
        Accessing vocational education and training                             Language and literacy services
        Assessing skills and abilities                                          Career planning
        Job search techniques in the Australian context                         Preparing a resume
        Interview techniques                                                    Preparing letters of application
        Addressing selection criteria                                           Telephoning for an interview
        Preparing for an interview                                              Cross cultural communication for job seekers
        Other sources of employment assistance                                  Commonwealth Government assistance – Centrelink, Job
                                                                                Services Australia and Disability Employment Services




                                                                       10
 Declaration


 I state that the information in this application and attachments is to the best of my knowledge true and correct. I agree that
 the information provided in this application will be used by the Department of Employment, Economic Development and
 Innovation (DEEDI), and that DEEDI may obtain additional information from appropriate agencies as required for
 assessment purposes. I understand that this is an application only and may not necessarily result in funding approval. I
 have read and understand the Skilling Queenslanders for Work or Training Places for Single and Teenage Parents or
 Productivity Places Program Memorandum of Agreement terms and conditions and program funding guidelines.



 Signature*                                                            Date       /      /


 Printed Name**                                                        Position

* To be signed by a person with delegated authority to apply for grant funding on behalf of the organisation i.e. Chairperson, Secretary or Treasurer
** Only printed name required for electronic submissions




                                                                            11
 Skilling Queenslanders for Work Application for Funding
 Application Checklist

Please check the boxes to indicate that the following documents have been attached to this application. If submitting an
application as a result of an Annual Performance Review with DEEDI only attach relevant documents to support any
changed or updated information and to confirm continuing support/contributions.

        Discussed this application with the DEEDI regional employment officer prior to submission  1300 369 925

        Checked closing dates for applications – can vary by program and by DEEDI region

        Completed application form using the Skilling Queenslanders for Work Instruction Booklet

        ABN has been provided in Section 2

        Project Plan has been completed – Attachment A

        Work Skills Traineeship competencies has been completed (where applicable) – Attachment B

        Skilling Queenslanders for Work budget worksheets have been completed and are attached

        Letters of support for in-kind/business financial contributions (where applicable) – separate letters will be required from each
        organisation contributing financially

        Answered questions relating to organisation’s financial viability

        A resume or brief background information has been provided for each person involved in the delivery of the project

        Letters of support for community involvement (where applicable)

        Approval letter from DET for vocational placement and evidence of required insurances (where applicable)

        Three (3) quotes included from registered training organisations for the provision of accredited training (where applicable) –
        must be on Departmental Training Quote proforma. Three quotes not mandatory for Work Skills Traineeships.

        Permission Letter and Suitability Check from DEEDI to deliver 30719QLD – Course in Adult Literacy/Numeracy or the
        equivalent replacement course (where applicable)

        Template letters from each host employer (where a host employer work placement model is used) – template letter to use is
        supplied at Attachment C




                                                                    12
Skilling Queenslanders for Work Application for Funding                                                                                                             ATTACHMENT A
Project Plan

WEEK/S   ATTENDANCE       TYPE OF ASSISTANCE                                SKILLS DEVELOPED/WORK ACTIVITIES   TRAINING TO BE COMPLETED                     OTHER COMMENTS
         PATTERN          (skills assessment, life skills activities, job                                      (include module hours and qualification or   (location, supervisor etc)
         e.g. 2 days pw   preparation, accredited training, work                                               course etc)
                          placement, post-participation support etc)
Skilling Queenslanders for Work Application for Funding                                                                                                                          ATTACHMENT B
Work Skills Traineeship (Business)                                                              BSB 10107 Certificate 1 in Business
                                                                                                (Nominal Hours: 148)
Packaging Rules:
Completion of six (6) units made up of one (1) core unit and five (5) elective units. Four (4) elective units must be selected from the elective units listed in Certificate I in Business.
One (1) elective unit may be selected from the remaining elective units in Certificate I in Business or any currently endorsed Training Package or accredited course at the same qualification level.

Select     Category                 Hrs         Code                 Title                                                    Workplace Task/Structured Training          Structured Training (SRTO
                                                                                                                              (Employer Responsibility                    responsibility)


           Core                     20          BSBOHS201A           Participate in OHS processes

           Elective                 30          BSBIND201A           Work effectively in a business environment

           Elective                 20          BSBWOR202A           Organise and complete daily work activities

           Elective                 40          BSBCMM101A           Apply basic communication skills

           Elective                 20          BSBLED101A           Plan skills development

           Elective                 15          BSBADM101A           Use business equipment and resources

           Elective                 20          BSBITU101A           Operate a personal computer

           Elective                 40          BSBITU102A           Develop keyboard skills

           Elective                 30          BSBITU202A           Create and use spreadsheets

           Elective                 20          BSBSUS201A           Participate in environmentally sustainable work
                                                                     practices
Include elective details below where an elective unit has been selected from another currently endorsed Training Package or accredited course at the same qualification level.
           Elective
Skilling Queenslanders for Work Application for Funding                                                                                                                       ATTACHMENT B
Work Skills Traineeship (Conservation and Land                                                ACH10110 Certificate 1 in Conservation and Land Management
Management)                                                                                   (Nominal Hours: 115)
Packaging Rules:
Completion of six (6) units made up of two (2) core units and four (4) elective units.
A maximum of four (4) elective units or four (4) units from units aligned to Certificates I or II in AHC10 or from any other currently endorsed training package or accredited course. Selected units
must be relevant to job outcomes in the conservation and land management industry.
NOTE: nominal hours for competencies are based on superseded qualifications as no transition guide has been developed

Select     Category                 Hrs        Code                 Title                                                   Workplace Task/Structured Training         Structured Training (SRTO
                                                                                                                            (Employer Responsibility                   responsibility)


           Core                     24         AHCOHS101A           Work safely

           Core                     24         AHCWRK101A           Maintain the workplace

           Elective                 24         AHCNAR101A           Support natural area conservation

           Elective                 24         AHCNAR102A           Support native seed collection

           Elective                 24         AHCCHM101A           Follow basic chemical safety rules

           Elective                 24         AHCMOM101A           Assist with routine maintenance of machinery &
                                                                    equipment
           Elective                 24         AHCNSY101A           Support nursery work4

Suggested electives that align with activities for standard environmental projects for SQW. However other electives can be selected from Certificates I or II in AHC10 or from any
other currently endorsed training package or accredited course.
           Elective – Cert II in    30         AHCNAR201A           Carry out natural area restoration works
           Conservation & Land
           Management
           Elective – Cert II in    24         AHCLSC201A           Assist with landscape construction work
           Conservation & Land                                      Note:
           Management
           Elective – Cert II in    35         AHCPGD201A           Plant Trees and Shrubs
           Horticulture
           Elective
Skilling Queenslanders for Work Application for Funding                                                                                                                          ATTACHMENT B
Work Skills Traineeship (Construction)                                                          CPC10111 Certificate 1 in Construction
                                                                                                (Nominal Hours: 268)
Packaging Rules:
To achieve this qualification, the candidate must demonstrate competency in eleven (11) units of competency made up of eight (8) core units and four (3) elective units.
The elective units are to be chosen as follows:
   up to three (3) units from the elective units below
   one (1) unit from Certificate I or II qualifications in CPC08 or another current Training Package or state accredited course, provided the integrity of the AQF alignment is ensured, and they
    contribute to a valid, industry-supported vocational outcome

Select     Category                 Hrs         Code                   Title                                                  Workplace Task/Structured Training          Structured Training (SRTO
                                                                                                                              (Employer Responsibility                    responsibility)


           Core                     20          CPCCCM1012A            Work effectively and sustainably in the construction
                                                                       industry
           Core                     20          CPCCCM1013A            CPCCCM1013A Plan and organise work

           Core                     20          CPCCCM1014A            Conduct workplace communication

           Core                     36          CPCCCM2001A            Read and interpret plans and specifications

           Core                     70          CPCCCM2005A            Use construction tools and equipment

           Core                     6           CPCCOHS1001A           Work safely in the construction industry

           Core                     20          CPCCOHS2001A           Apply OHS requirements, policies and procedures
                                                                       in the construction industry
           Core                     40          CPCCVE1011A            Undertake a basic construction project

           Elective                 16          CPCCCM1011A            Undertake basic estimation and costing

           Elective                 20          CPCCCM1015A            Carry out measurements and calculations

           Elective                 16          CPCCCM2004A            Handle construction materials

One (1) unit from Certificate I or II qualifications in CPC08 or another current Training Package or state accredited course as per packing rules above
           Elective
Skilling Queenslanders for Work Application for Funding                                       ATTACHMENT B
Host Employer Template Letter
Name
Title
Sponsor organisation
Sponsor address
Sponsor address


Dear

           Re: Skilling Queenslanders for Work – Work Placements Project
I wish to confirm that this organisation,  (Host Organisation Name)      , is interested in providing a
work placement position as part of the Skilling Queenslanders for Work project managed by (Sponsor
Organisation Name).
We agree to the following conditions regarding the placement of participants (please tick):
           We will provide the necessary facilities, range of work, supervision and training required for
            the work placement
           Existing workers will not be displaced by work placement participants
           This organisation confirms its status as a not-for-profit organisation
           We have current public liability insurance for a sum of not less than $10,000,000 arising
            from any one event in respect of death, injury, loss of damage howsoever sustained to any
            person or property

The work placement participant/s will complete the following Work Skills Traineeship:
           Work Skills Traineeship (Business)
           Work Skills Traineeship (Conservation & Land Management)
           Work Skills Traineeship (Construction)
(Attachment B must also be completed detailing the accredited competencies that will be completed by
participants from the corresponding Certificate I qualification)

For host employer work placement model projects, the projects or activities to be undertaken by the
work placement participant must be additional to the host employer’s core business and have
community or public benefit. As with all work placement projects, a host placement should also be
appropriate to the participants’ skill level; address identified local skills shortages and lead to further
employment opportunities.

The project/additional activity must be nominated by the host organisation and approved by the
Department of Employment, Economic Development and Innovation (DEEDI) prior to commencement.
                                                             -2-


Please provide a brief summary of the project or additional activity
that will be undertaken by the work placement participant/s.

Some Examples include:
Business
Quality assurance preparation work, statistical collection and
reporting, promotional work, assistance with major organisational
projects etc.
Construction
Construction of new facilities, upgrading existing facilities,
installation of fencing etc.
Conservation and Land Management
Landscaping of facilities, planning and designing a community
garden, installation of irrigation systems etc.


We are pleased to support (Sponsor organisation name)                  by providing this additional information
for their Skilling Queenslanders for Work funding submission.

Signed:

Title:

Organisation Contact Name:

Contact Number:

Date:


DEPARTMENTAL OFFICE USE ONLY
App ID
Date Received:
APPROVED                       Comments (if applicable):




REGIONAL DIRECTOR/OPERATIONS MANAGER
[Region]
   /    /
Advice sent to organisation:

								
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