Cooperative Education Program Student AgreementCooperative Education Agreement • July 23rd, 2023
Contract Type FiledJuly 23rd, 2023STUDENT CONTACT INFORMATION Shop: YOG: Student’s Name: (First) (Middle) (Last)Home Address: (Number) (Street)City/Town: State: Zip Code: Home Phone # Cell Phone # Email: WORK PERMIT INFORMATION (ONLY FILL IN IF YOU ARE UNDER THE AGE OF 18) Place of Birth: Date of Birth: / / Gender: ________Hair Color: Eye Color: Distinguishing Facial Marks: ______________________________________________________________________ STUDENT EMPLOYMENT INFORMATION Do you agree to follow all the rules and regulations for participation in this program as outlined in the student handbook? ❒ Yes ❒ No Are you a U.S. Citizen? ❒ Yes ❒ No Do you have transportation to/from work? ❒ Yes ❒ No Do you have a driver’s license? ❒ Yes ❒ No Are you available to work part time after school if requested? ❒ Yes ❒ No