Common Contracts
1 similar Work-Based Learning Agreement contracts
Work-Based Learning Agreement Form (FORM A)Work-Based Learning Agreement • December 9th, 2020
Student Information Name: R# Phone: Date Program/Major Term: Fall ☐ Spring ☐Summer☐ Student Demographic InformationYour response is voluntary, information will not be used in a discriminatory manner and will remain confidential to individualstudents and only reported in general aggregate data Gender: 1st generation college student☐ Ethnicity Employer Information Employer Name Phone Number Address City State Zip Supervisor’s Name Supervisor’s Phone Number Supervisor’s Email: Position is with current employer☐ Position is new employer☐ Learning Plan Position Title: Start DateClick here to enter a date. End DateClick here to enter a date. Work days & Hours Hourly wage Planned Work Activities/ What I will learn. 1. 2. 3. 4. 5. This agreement is entered into with the expectation on the employer’s part and the understanding on my partthat I will complete the above employment during the specified period of time. Student signature DateClick here to enter adate. Employer signature DateClick her
