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Balai Bahasa Indonesia Perth (Inc) in collaboration with the Consulate General of the Republic of Indonesia Western Australia, and Department of Education
Western Australia
APPLICATION FORM
Indonesian Language Assist ant Program of West ern Aust ralia
January - December 2018Bef ore f illing in t his int eract ive f orm, make sure you have read t he LAP Guidelines 2018. These can be f ound at www. balaibahasapert h. org/ language-assist ant -program or
ht t p: / / kj ri-pert h. org. au
Follow all direct ions in t he LAP Guidelines 2018 when complet ing and submit t ing your applicat ion via email.
Each sect ion of t his applicat ion f orm must be complet ed.
Type in t he spaces provided, save a copy and email t oget her wit h t he support ing document s list ed in t he Guidelines t o lap@balaibahasapert h. org .
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I. PERSONAL DETAILS
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III. EMPLOYMENT DETAILS
Year Position Employer
2017
2016
2015
IV. LANGUAGE
No Language level
1 English
V. Professional development (Seminars/ Courses/ Training)
No Course Institution Place Date
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3
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5Use this space to add any dditional professional development that may be relevant:
VI. Social Activities
No Organisations Positions Years
1
2
3
4
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VII. Persons to be notified in Indonesia in case of emergency:
Name:
Relat ionship:
Address:
Telephone:
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Use this space to add additional informat ion you may wish the selection panel to consider:
VIII. Declarations
If accept ed f or t he Program, I agree t o:
Abide by t he regulat ions of t he Depart ment of Educat ion of West ern Aust ralia.
Accept t o work out side t he cit y of Pert h during t he program, as required.
Act ively promot e Indonesian language and cult ures in West ern Aust ralian Schools.
Accept responsibilit y f or my daily f inancial requirement s (e. g. accommodat ion, f ood,
clot hing, ut ilit iesand ot her necessary expenses) during t he program.
I cert if y t hat t he st at ement s I have made in response t o t he f oregoing quest ions are t rue, complet ed and correct t o t he best my knowledge.
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Dat e Signat ure
Applicat ions close Friday 30 June 2017
