Your Name (required)

Your Email (required)

Contact Number (required)

Your Age (required)

Do you have a Working with Children Check? (required)
YESNONOT YET
Do you have a Police Check? (required)
YESNONOT YET
Name of School/Institution (required)

School Address (required)

Course Details (required)

Number of Hours Required

Days of Availability (required)

Why would you Like to complete your placement with Bridge Builders?

Name of Placement Coordinator (required)

Placement Coordinator Contact Number (required)

Placement Coordinator Email (required)

Will your placement coordinator be visiting you while on placement? (required)

Do you have a placement manual with required tasks to be completed during placement?

Do we need to complete any reports or evaluations for your placement?

Area of interest
UR Retreat 4 Young WomenBB Nights/ Youth GroupOffice TeamCounsellingPostie Bike RideThe CriBB Cafe