WORK-BASED TRAINING AGREEMENTWork-Based Training Agreement • April 14th, 2020
Public and Products Liability Protection: ACSMLA01 Professional Indemnity Insurance: 03 MIS 1825426 School Student Accident Cover : 1102/K00106/19003 Workers Compensation: IAD151082350
WORK-BASED TRAINING AGREEMENTWork-Based Training Agreement • July 22nd, 2020
WORK-BASED TRAINING AGREEMENTWork-Based Training Agreement • November 16th, 2016
WE AGREE to the Work-based Training of the student with the Work-based Training Provider on the following terms, covenants and conditions:
WORK-BASED TRAINING AGREEMENTWork-Based Training Agreement • July 22nd, 2019
Work Based Training Agreement & Training Plan - General EducationWork Based Training Agreement • September 14th, 2020
Student / Learner Information Student Name: Grade: Date of Birth: Home Phone: Address: City: State: MI Zip: Emergency Contact Name: Contact Phone #: District Information: School District: School Building: Date(s) of Safety Instruction: Number of credit hours to be granted: Concurrent related academic course: Type of Placement: (Check One) Paid Work-Based Unpaid Work-Based Employer / Employment Information (Complete for external placements only Paid or Unpaid) Employer Name: Supervisor Name: Employer Address: Employer Phone #: City: State: MI Zip Code: Worker’s Disability Carrier: Policy No: Liability Insurance Carrier: Policy No: Job Title / Assignment: Starting Wage: Begin Date: End Date: This Assignment is (Check One): Marking Period Semester School Year Hours to be worked / Scheduled (Hours scheduled for working must occur during scheduled classroom time): MON TUES WED THUR FRI SAT SUN Earliest
Work Based Training Agreement & Training Plan Special EducationWork Based Training Agreement • September 14th, 2020
Student / Learner Information Student Name: Grade: Date of Birth: Home Phone: Address: City: State: MI Zip: Emergency Contact Name: Contact Phone #: District Information School District: School Building: Date(s) of Safety Instruction: Employer Information Employer Name: Supervisor Name: Employer Address: Employer Phone #: City: State: MI Zip Code: Worker’s Disability Carrier: Policy No: Liability Insurance Carrier: Policy No: Out of District Placement Information Type of Placement: Out-of-District Non-CTE Unpaid Special Education Work-Based Learning Experience Job / Position Title: Placement Begin Date: Placement End Date: Hours to be worked MON TUES WED THUR FRI SAT SUN Earliest Latest In District Placement Information In-District placements MUST be directly related to post-secondary career and employment goals and objectives in thepupils Transition Services Plan developed for special education services.
WORK BASED TRAINING AGREEMENTWork Based Training Agreement • June 9th, 2014
WE AGREE to the Work-Based Training of the student with the Work-Based Training provider on the following terms, covenants and conditions:
