Agreements and Signatures Sample Clauses

Agreements and Signatures. Student Intern: I concur with and accept the academic and work assignments indicated above. I understand and will adhere to the internship registration procedure and the policies outlined on the Experiential Learning Waiver. I accept the obligation of confidentiality in my work and will familiarize myself with and adhere to the organization’s relevant policies/procedures and appropriate standards and ethical conduct. _______________________________________________________________________________ Student Intern Signature Date Internship Site Supervisor: I have discussed the internship with the Student Intern and we have agreed upon the assigned work components appearing above. I agree to provide training and consultation to the Student Intern in order to achieve the above learning objectives, provide information concerning our organizational policies and procedures, meet with the Student Intern regularly, and provide a written evaluation of the Student Intern at the end of the term. (I understand that an “employer evaluation” will be mailed to me). _______________________________________________________________________________ Internship Site Supervisor Signature Date Faculty Internship Sponsor: I have discussed the academic component of this internship with the student intern. We have reached agreement on the learning objectives as indicated above. I further agree to meet regularly with the Student Intern to discuss the internship experience. I will conduct an assessment/evaluation and do an on-site visit if possible. _______________________________________________________________________________ Faculty Internship Sponsor Signature Date ___________________________________
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Agreements and Signatures. A. DISTRICT OF CHOICE/PLACEMENT – This signature is required for both discretionary and mandatory agreements. The Board of Trustees: ⬜ DISAPPROVES ⬜ APPROVES this application subject to receipt of transportation/tuition charges stated on the application. Print Name of Chairperson, Board of Trustees: Signature of Chairperson, District of Choice/Placement: Date:
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Agreements and Signatures. Employer: I have reviewed this Internship/Field Work Agreement with the student and we have agreed upon the assigned work and learning components appearing above. I agree to provide assistance, training, consultation and periodic review in order to assist the student in meeting his or her goals and primary learning objectives; and provide an orientation to our organization, policies and procedures. I understand that the student must report to the place of business and working from home or in a home-based business does not constitute an internship. I will submit an end of term review of the student’s work performance after discussing it with the student. Employer signature Date Division Faculty Internship/Field work Supervisor: Faculty Signature Date Division Chair: Chair Signature Date Student: Student Signature Date Assistant Xxxx: Assistant Xxxx Signature* Date *I acknowledge that the requirements for this class comply with all established University, college, and divisional policies related thereto, including but not limited to the credit hour policy, academic policies, and Xxxxxx student policies and procedures. PEPPERDINE UNIVERSITY XXXXXX INTERNSHIP/FIELD PROGRAM ASSUMPTION OF RISK, WAIVER OF LIABILITY,
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Agreements and Signatures. Employer: I have reviewed this Internship/Field Work Agreement with the student and we have agreed upon the assigned work and learning components appearing above. I agree to provide assistance, training, consultation and periodic review in order to assist the student in meeting his or her goals and primary learning objectives; and provide an orientation to our organization, policies and procedures. I understand that the student must report to the place of business and working from home or in a home-based business does not constitute an internship. I will submit an end of term review of the student’s work performance after discussing it with the student. Employer signature Date Program Director: Director Signature Date Student: Student Signature Date International Programs Xxxx: Xxxx Signature* Date *I acknowledge that the requirements for this class comply with all established University, college, and divisional policies related thereto, including but not limited to the credit hour policy, academic policies, and Xxxxxx student policies and procedures.
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Agreements and Signatures 
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Related to Agreements and Signatures

  • Required Signatures a. Curriculum Academic Xxxx(s) b. Curriculum Chair(s)

  • Counterparts and Signatures The Agreement may be executed in multiple counterparts, each of which shall be deemed an original, but all of which taken together shall constitute one and the same instrument. A Party may evidence its execution and delivery of the Agreement by transmission of a signed copy of the Agreement via facsimile or email. In such event, the Party shall promptly provide the original signature page(s) to the other Party.

  • AGREEMENT SIGNATURES By signing below, both parties agree to the terms and conditions of this Agreement. Please acknowledge acceptance of this document and terms by returning a signed copy within seven (7) days of issuing. If a signed copy is not returned within seven (7) days and you are attending service, Fighting Chance will deem this to be acceptance of the document. If signed by Xxx XxxXxxxxxxX: Signature of Participant: Date: If signed by Person Responsible: I confirm that this Agreement has been explained to the individual receiving the services and that they agree to the terms. I further confirm that I have authority to sign on their behalf. Signature of Person Responsible: Date: SignaĒure on behalf of FighĒing Chance: Signature of Person(s) responsible: Date: Name: Appendix 1 Key Contact Details Participant’s Name Participant’s Email Participant’s Phone Participant’s Address Person(s) responsible’s Name Person(s) responsible Relationship to Participant Person(s) responsible’s Email Person(s) responsible’s Phone Support Coordinator (where applicable) Support Coordinator’s Name Support Coordinator’s Email Support Coordinator’s Phone Shared Living/Supported Accommodation/Group Home (if applicable) House Manager’s Name House Manager’s Email House Manager’s Phone Additional Contacts (if applicable) Role Contact’s Name Contact’s Email Contact’s Phone Appendix 2 NDIS Claiming Preferences Fighting Chance supports NDIS participants who are NDIA-Managed, Self-Managed or Plan Managed. To invoice and bill you correctly, it is important you keep us updated with your plan management preferences, and let us know ongoing if your status changes. For the purposes of services delivered by Fighting Chance, your NDIS plan is: (please tick) ☐ NDIA-MANAGED You understand that Fighting Chance will claim directly through the NDIA portal if your funding for Fighting Chance is NDIA-managed, so you will not receive any direct request for payment from us. To ensure that you do not get a text from the NDIA to approve each claim weekly, endorse Fighting Chance as a ‘My Provider’ for automatic payment processing. Instructions can be found at xxxxxxxxxxxxx.xxx.xx/xxxx/ or you can contact the Fighting Chance My Provider Endorsement Helpdesk on (00) 0000 0000 or xxxxxxxxxxxxxxx@xxxxxxxxxxxxx.xxx.xx ☐ (Optional) Please supply me, by email, with monthly Statements of Account to: ☐ SELF-MANAGED ☐ I am self-managed and would like to be invoiced for services once a week. Please email invoices to: Please see Appendix 3 for Self-Management Payment Options. ☐ PLAN-MANAGED Please send invoices to my plan manager: Plan management organisatio Contact Name Email Address Phone number ☐ OTHER FUNDING (eg. self-funded, iCare or other insurance funding) Please email invoices to: Appendix 3 Self-Managed Payment Options Participants who are self-managed have a number of payment options with Fighting Chance: ☐ DIRECT DEPOSIT (preferred option) Payment of Fighting Chance invoices can be made by Electronic Funds Transfer (EFT) through your bank. Fighting Chance’s bank account details are as follows: Bank: Commonwealth Bank of Australia Account Name: Fighting Chance Australia Ltd BSB: 062-438 Account Number: 00000000 To ensure all payments are correctly allocated to your account, please include the full invoice number in the reference field. ☐ CREDIT CARD Payments can be made by credit card by clicking the ‘pay by credit card’ link included on the invoice. Please note that a service fee for this option will be imposed. ☐ PAYPAL Payment of your invoices can also be made via our PayPal account. To make payment via PayPal, please access the following link: xxxxx://xxxxxx.xx/FightingChanceAus?locale.x=en_AU To ensure your payment is correctly allocated, please enter the full invoice number in the reference field. Appendix 4 Non Face to Face Time Breakdown - Jigsaw Standard Non Face-to-Face Supports Delivered to every Jigsaw Participant daily, weekly, annually Writing the Board (i.e. preparing and writing up each person’s individualised program for the following day). Reviewing Trainee records/journal notes/medical or other key information to be able to best support the person during their day. Parent/Guardian/Carer Updates, i.e. emails, phone calls. Pre- and post-shift sta briefings. Zone setup (setting up workstations, boxes, visuals and group training areas) Resource development to support each Trainee to progress towards their employment goals (adapting training resources, creating visual aids and cheat sheets, etc). Research/Coordination to implement support strategies (disability, behavioural and learning strategies). Family reviews and the development of training plans (planning, delivery and follow up). Planning social events and extra curricular training (e.g. TAFE). Standard NDIS Annual Support Review Letter. Standard Ǫuarterly Reports - Upon Request. Complex Non Face-to-Face Supports - Delivered to Jigsaw Participants with High Intensity Support Needs (in addition to supports outlined in Standard) Allied health meetings, phone calls, correspondence. Specialist/additional sta training (internal or external), i.e. BSP implementation training. Creation of additional/detailed social stories/visuals. Data collection requested by behaviour therapists. Incident follow up or crisis meetings (seperate to regular family updates or regular allied health meetings). Development/review/discussion of medication forms/transfer plans/mealtime assistance plans etc. Detailed and regular sta training on individual complex behaviour/medical/transfer/mealtime support plans. Extended daily pre-brief and debrief. Additional Non Face-to-Face Supports - billed separately upon request Detailed NDIS Review Letters One-o engagement or training with Allied Health. Detailed Ǫuarterly Reports.

  • Authorized Signatures (1) Each of the undersigned represents that he or she is fully authorized to enter into the terms and conditions of, and to execute, this Settlement Agreement on behalf of the Parties identified above their respective signatures and their law firms.

  • Student Signature By signing this contract, Resident agrees to pay the contract amount (room, board and association fees) in accordance with Addendum B: Rate and Payment Schedule. Resident may pay the full amount due prior to the due date, at the Resident’s election.

  • Contract Signature If the Original Form of Contract is not returned to the Contract Officer (as identified in Section 4) duly completed, signed and dated on behalf of the Supplier within 30 days of the date of signature on behalf of DFID, DFID will be entitled, at its sole discretion, to declare this Contract void. No payment will be made to the Supplier under this Contract until a copy of the Form of Contract, signed on behalf of the Supplier, is returned to the Contract Officer.

  • Authorized Signatories The parties each represent and warrant to the other that (1) the persons signing this lease are authorized signatories for the entities represented, and (2) no further approvals, actions or ratifications are needed for the full enforceability of this Lease against it; each party indemnifies and holds the other harmless against any breach of the foregoing representation and warranty.

  • EMPLOYEE SIGNATURES Signature: Phone # / Personal E-mail: Signature: Phone # / Personal E-mail: Signature: Phone # / Personal E-mail:

  • Counterpart Signatures For the purpose of facilitating the recordation of this Agreement as herein provided and for other purposes, this Agreement may be executed simultaneously in any number of counterparts, each of which counterparts shall be deemed to be an original, and such counterparts shall constitute but one and the same instrument.

  • COUNTERPARTS; FACSIMILE AND SIGNATURES This Settlement Agreement may be executed in counterparts and by facsimile or pdf signature, each of which shall be deemed an original, and all of which, when taken together, shall constitute one and the same document.

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