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* 1. Student Name

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* 2. CareGroup

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* 3. Email Address

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* 4. Have you completed the Workplace Induction? - If you have not, please exit out of this survey.

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* 5. First preferred employer? eg Aquest Electrical

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* 6. Second preferred employer

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* 7. What are your preferred dates? Please include a 5 day period eg. 1/1/21-5/5/21 or Term 1, week 1

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* 8. Agreement

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