Silver Valley School to Work Work-Based Learning Training Agreement
Student Trainee_______________________________ Date of Birth_____________________
Address__________________________________________ Telephone__________________
School___________________________________________ Telephone__________________
The (training agency)____________________ will permit (student)_______________________
to enter their establishment for the purpose of gaining knowledge and experience as
a (job title)_____________________________ for the 20_ _/20_ _ school year.
The student will be assigned to (training agency/location)___________________ for at least 10
hours per week beginning (start of semester)________ and ending (end of semester)__________.
The student's career objective is _________________________________________________.
The student will be paid $______ per hour. The student's work schedule will normally be from (starting time)_________ to (ending time)_________ on S M T W TH F SAT (circle appropriate days) or variable hours of _____________________________________________________.
Student Trainee's Responsibilities
School/Coordinator Responsibilities
Employers Responsibilities
This is not a contract but an agreement.
___________________________ Student Trainee / Date |
____________________________ Parent/Guardian / Date |
___________________________ Company Name - Training Agency |
______________________________ School-to-Work Coordinator / Date |
____________________________ Company Address / Phone Number | _______________________________ Supervisor Signature |
____________________________ Date |
_______________________________ Supervisor Name (Printed) |
Silver Valley School-to-Work
Travel/Riding Permission Form
(Student must have this form signed if he or she is going
to drive or get a ride to work)
I hereby give my permission for __________________________to participate in a School to Work Work-Based Learning experience and to travel to and from the activity by private automobile driven by _______________________.
I further understand that the district's liability insurance covers the district only and does not cover the possible liability of the driver/owner of the private vehicle when the student is on such a trip in a privately owned vehicle.
Signature of Parent or Guardian _____________________________
Date
_____________________
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