PIPS

Organisation Detail

Name*

Host Industry Type

Website Url*

ABN*

About Organisation*

Organisation Address

Country*

Country Other

Address Search

Enter Address Manually

Street Address*

Street Address2

Street Address3

City / Suburb*

State / Province*

Zipcode / Postcode*

Organisation Contacts

Nominate staff members and assign one or more roles to each. Please provide at least one Primary Contact and one Delegated Signatory.

Contact

Salutation*

First Name*

Last Name*

Position*

Email*

Phone*

Phone number must contain 9–15 digits with no spaces between numbers.

Primary Contact

Delegate Signatory

HR / Compliance Contact

Contact

Salutation*

First Name*

Last Name*

Position*

Email*

Phone*

Phone number must contain 9–15 digits with no spaces between numbers.

Primary Contact

Delegate Signatory

HR / Compliance Contact

About Your Organisation

Please answer the following questions to help us better understand your organisation and your interest in the program.

How did you hear about our internship and project program?*

---------

Via Faculty communication

University of Melbourne website

Previous participant in the program

University of Melbourne alumnus

Word of mouth

Other (please specify)

If other, please specify

What is your primary motivation for participating in the program?*

Is your organisation interested in ongoing student internship/project partnerships or other Faculty initiatives and employer engagement programs? If so, please briefly describe what you have in mind.

How long has your organisation been in operation?*

What is the size of your organisation in terms of full-time employees?*

Occupational Health & Safety (OH&S)

Please describe your organisation’s approach to workplace health and safety, including any relevant policies or procedures in place.*

Do you provide a workplace health and safety induction for new staff, students, or visitors? If yes, please confirm that this includes: -Emergency and evacuation procedures -First aid arrangements -Site rules and restricted areas -Processes for reporting hazards, near misses, and incidents*

What is your organisation’s immediate response process if a student is injured or becomes unwell while on site?*

Please upload at least one relevant documentation outlining your workplace health and safety policies or procedures (e.g. OHS policy, induction materials, risk management procedures).*

File Upload

Accepted formats: PDF, DOC/DOCX; Max 2MB

File Upload

Accepted formats: PDF, DOC/DOCX; Max 2MB

File Upload

Accepted formats: PDF, DOC/DOCX; Max 2MB

Incident Management

Do you have a documented incident management procedure that includes: Incident reporting and escalation Immediate response and management Investigation processes Corrective actions and review*

Does your incident management procedure explicitly apply to students or interns on placement (not only employees or contractors)?*

Do your procedures address legally reportable/notifiable incidents under applicable workplace health and safety laws, including requirements to notify the relevant regulator or authority where required?*

Do your procedures require preservation of the incident site for notifiable/reportable incidents, except where disturbance is necessary to: -Assist an injured person -Remove immediate danger -Make the site safe until otherwise directed by the relevant authority*

Do you maintain incident records in accordance with legal requirements, including retention for the required statutory period?*

Please upload at least one relevant documentation outlining your organisation’s incident management processes (e.g. incident management policy, reporting procedures).*

File Upload

Accepted formats: PDF, DOC/DOCX; Max 2MB

File Upload

Accepted formats: PDF, DOC/DOCX; Max 2MB

File Upload

Accepted formats: PDF, DOC/DOCX; Max 2MB

Young Workers and Interns

As you will be engaging young workers and interns, you must agree to the following responsibilities:

Providing employees and interns with information, instructions, training, and supervision needed for them to do their job safely
Providing employees and interns with induction materials and training, and ensuring they are familiar with the workplace, host organisation policies, incident and hazard reporting mechanisms, safe work procedures, and other relevant requirements
Providing and maintaining safe machinery and equipment
Ensuring that employees and interns use, handle, store, or transport plant or substances safely
Providing safe systems of work, for example, systems to prevent falls on slippery surfaces
Maintaining the workplace so it is safe and without risks to health, including providing adequate facilities for the welfare of employees
Providing health and safety information in suitable languages, including the names of contacts for health and safety matters
Providing employees and interns with adequate supervision throughout their placement

You can learn more about young workers’ rights by visiting the WorkSafe Victoria website .

I have read and agree to the above requirements.*

---------

Yes

Review and Submit

Organisation Detail

Organisation Contacts

About You

OH&S

Incidents

Declaration

Acknowledgement

By submitting this form, I confirm that:

The information provided is accurate and complete to the best of my knowledge
I have the authority to register this organisation as a student placement host
I understand that this registration is subject to verification and approval by the university
I acknowledge that the personal information collected will be used to administer the placement program in accordance with this system's privacy collection notice

I agree to the above

Host Registration form (FEIT)

Organisation Detail

Organisation Contacts

About Your Organisation

Occupational Health & Safety (OH&S)

Incident Management

Young Workers and Interns

Review and Submit

Organisation Detail

Organisation Contacts

About You

OH&S

Incidents

Declaration

Acknowledgement