Intern Application Form for Agents & Partners Agent / Partner DetailsAgent / Partner Company Name*Your Name* First Last Agent / Partner Email* Your email addressApplicant DetailsName* First Last Email Address* Date of birth* Date Format: DD slash MM slash YYYY Gender*MaleFemaleAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone (home) (include country/city codes)Phone (mobile) (include country/city codes)Skype IDIs the applicant a permanent Australian resident/citizen?*YesNoPassport DetailsCountry of citizenshipFirst visit to AustraliaYesNoIs the applicant eligible for a Working Holiday Visa 417 or 462*YesNoIf you are unsure, visit http://www.immi.gov.au/Visas/Pages/417.aspx & http://www.immi.gov.au/Visas/Pages/462.aspxEnglish language skillsLowIntermediateStrongFluentEmergency Contact DetailsTheir Name First Last Relationship to the applicantTheir phone number (include country/city codes)Their Email Details of InternshipMinimum duration of internship (number of weeks)*Note – Internship duration is typically a minimum of 12 weeks. Some exceptions apply.Maximum duration of internship (number of weeks)Note – Internship duration can be a maximum of 26 weeks.Earliest internship start date* Date Format: DD slash MM slash YYYY Latest internship start date Date Format: DD slash MM slash YYYY Available Internship Reference Number (if applicable)Internship Industry (1st preference)* Marketing Event Management Tourism Finance Communication Logistics Public Relations Human Resources Graphic/Web Design Information Technology Hospitality Education Fashion Online Marketing Media Social Work Administration Other Please choose one '1st preference'Other IndustryIf '1st preference' industry of interest is not listed above, please provide here.Internship Industry (2nd preference) Marketing Event Management Tourism Finance Communication Logistics Public Relations Human Resources Graphic/Web Design Information Technology Hospitality Education Fashion Online Marketing Media Social Work Administration Other Please provide a maximum of 3 fields from the secondary preferences. Note – While we will make every effort to arrange an internship in the chosen industry, factors such as education and experience as well as the current industry availability may affect successful placement.Other IndustryIf '2nd preference' industry of interest is not listed above, please provide here.Completed, or completing a tertiary qualification in requested industry of internship*YesNoRequested Internship Location* Flexible Sydney Melbourne Brisbane Gold Coast Perth Other Other LocationIf requested location is not listed above, please provide hereExpectations of the internshipPlease provide brief details of what the applicant wants to achieve from the internship and the skills they wish to gain. This should be addressed more comprehensively in the cover letter.Any additional information about the internship requestAdditional ServicesAccommodation assistance requiredNoYes - HomestayYes - Furnished Student PropertyYes - FlexibleIf 'yes', please complete the accommodation application form found in 'Extra Services' http://www.internshipsdownunder.com/extra-services/accommodation/Will the applicant require an Airport TransferYesNoIf 'yes', please complete the Airport Transfer application form found in 'Extra Services' http://www.internshipsdownunder.com/extra-services/airport-transfer/Will the applicant require assisitance arranging insuranceYesNoIf 'yes', please complete the Insurance application form found in 'Extra Services' http://www.internshipsdownunder.com/extra-services/insurance/Medical InformationDoes the applicant have a health problem or disability which may affect their training as part of an Internship with a Host Organisation*NoYesPlease provide detailsDoes the applicant have any special requirements or require special equipment to perform their duties as part of an Internship with a Host Organisation*NoYesPlease provide detailsDoes the applicant have a health problem or disability that will require them to take medication during the Internship period*NoYesPlease provide detailsIf required by the Host Organisation, does the applicant agree to attend a medical examination prior to commencing their Internship Program*YesNoACKNOWLEDGEMENTTerm 1* The information given on this application form is to the best of my knowledge complete and correct and I understand that Internships Down Under shall have the right to terminate the Internship Placement at any stage if proven otherwise. Term 2* Should any changes to these details be made at any time before and during the Internship, I will inform Internships Down Under immediately. Term 3* I have informed the applicant and they understand, acknowledge and agree that it is a condition of Internships Down Under that prior to any Internship with a Host Organisation, the intern obtains insurance cover for Medical, Accident, Travel and Personal Liability and such copies are forwarded to Internships Down Under & the Host Organisation. Term 4* I have informed the applicant and they understand, acknowledge and agree that the internships arranged by Internships Down Under are not employment, but are a voluntary unpaid temporary training experience which does not lead to employment. Document Upload Drop files here or Please upload cv, cover letter, recent colour photo, and any other essential documents (maximum 8 files, total 10mb). Please email additional documents if required.