Common Contracts
1 similar null contracts
Work Based Training Agreement & Training Plan - General EducationSeptember 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
