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ACCHS Work Placement Attendance Record v1.0 Dec2022

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Australian College of Community and Health Services Pty Ltd t/a

Australian College of Community and Health Services (ACCHS)


Head Office: U102, Level 1 30 Cowper Street, Parramatta NSW 2150
RTO: 45182 CRICOS: 03687F ABN: 18 609 896 755

Work Placement Attendance Record


This form is to be used by students who are currently enrolled in classroom based training, in order to document
completion of the work placement attendance hours.

Student’s name:
Qualification:
Workplace name and
location:

Instruction to the student: The following table must be completed each and every day you attend work placement.
Ensure your Workplace Supervisor initials each day you are present and signs in the space below. This completed form
is to be submitted to your Trainer and Assessor or field coordinator at your first day back at training. A total of 120 hours
of work placement must be completed throughout the duration of your course as per your course schedule. You will
need to submit more than one form.

Total
Work hours for Workplace
Placement Date Time In Time Out Lunch Time In Time Out day Supervisor
Days (excluding initials
lunch)
Mon 01/01/11 9.00am 12.30pm 30 min 1.00pm 5.00pm 7.5 SP

Workplace Supervisor’s Name:

Workplace Supervisor’s Signature:

Date:

Trainer and Assessor Name:

Trainer and Assessor Signature:

Date:

Course Code:

© Australian College of Community and Health Services


Work Placement Attendance Record | Version 1.0 | Dec 2022
1|Page

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