Structured workplace learning arrangement form
All structured workplace learning arrangements in Victoria or in a reciprocating state must be made using the mandatory , as required by Ministerial Order 1412. All sections of this form must be completed and signed before the structured workplace learning commences.
Note: The structured workplace learning arrangement form must not be used to make an arrangement in a state or territory which is not a reciprocating state.
The arrangement form must be signed by:
the parent/carer of the student (if the student is under 18 years of age)
the principal or acting principal (this authority cannot be delegated to an assistant principal/campus principal or other member of staff)
A copy of the arrangement form signed by the principal must be provided to each party. The principal must retain the original copy.
Variations or amendments to the arrangement form may only be made in writing and must be signed by the employer, student, parent/carer (if the student is under 18 years of age) and the principal.
Note: It is preferable that an original copy of the arrangement form is signed by all parties, but it is acceptable for an employer to sign and fax, or scan and email, the form to the school, as long as the final copy of the arrangement form signed by the principal is clear, legible and has not had any information obscured or cut off during the fax/scan process. A copy of the form signed by the principal must be provided to each party.
Retention of the structured workplace learning arrangement form
If the employer advises the principal that the industry to which the structured workplace learning arrangement relates includes potential exposure of the student to scheduled carcinogenic substances and/or other hazardous substances, the principal must retain a copy of the arrangement form for 30 years from the date the student last worked at the employer’s workplace.
If a WorkSafe Insurance claim is made, remarks relating to the structured workplace learning (including the claim number and details of any injury or illness) must be retained with the relevant arrangement form. Copies of all relevant medical certificates are also to be retained by the school.
Reviewed 10 November 2023