Fill - AGREEMENT COOPERATIVE WORK EXPERIENCE (Clackamas Community College)

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Page1

CWEAgreementForm:Updated2.22.1 6 

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COOPERATIVE WORK EXPERIENCE

AGREEMENT

Instructions:ThisisaformalagreementbetweentheEmployer/SiteSupervisor,thecollege,andthestudent.

Alloftheinformationrequestedandsignaturesontheagreementarerequired.

Student:SubmitcompletedformtoyourCWEInstructorbeforestartingyourCWE.

STUDENT INFORMATION

________________________________________________________ ____________ _________________________

STUDENTNAMESTUDENTID#PROGRAMOFSTUDY

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_________________________________________ ___________________________________

PHONEE‐MAIL

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CWE SITE INFORMATION

______________________________________________________ ______________________________________ 

CWESITE(COMPANY/AGENCYNAME)SITESUPERVISOR(FIRST&LASTNAME)

___________________________________ __________________________________ _

COMPANYADDRESSCITYZIPCODE

_________________________________________ ________________________________

SUPERVISOR’SPHONESUPERVISOR’SE‐MAIL

_______________________________________________________________________

TRAININGSTARTDATETRAININGENDDATEHOURS/TERM#OFCREDITSTERM(SU,FA,WI,SP)

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_________________________________________________________

STUDENTJOB/CWEPOSITIONTITLE

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CWE INSTRUCTOR INFORMATION

______________________________________________ ________ _______________________________________ 

CWEINSTRUCTORNAMEPHONEE‐MAIL

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SEE TERMS AND CONDITIONS (on page 2)

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Cooperative Work Experience (CWE)

Community Center – Advising & Career Services

(503) 594-3511 | cwe@clackamas.edu

www.clackamas.edu/cwe

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Page2

CWEAgreementForm:Updated2.22.16

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TERMS AND CONDITIONS

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A. TheStudent/Employeeagreesto:

 beenrolledinaClackamasCommunityCollegeprogramwhichoffersCooperativeWorkExperience;

 interviewandsecureajobapprovedbytheprograminstructorandrelatedtohis/herareaofstudy;

 registerfortheappropriatenumberofcreditsintheCWEclassandregisterforaCWEseminar;

 worktherequirednumberofhoursduringtheterminrelationtothenumberofcreditsrequested;

 developasetoflearningoutcomesinconjunctionwiththeCWEinstructorandtheemployer;

 immediatelyinformtheCWEinstructorofanyproblemorchangesin

jobresponsibilities;

 abidebytheregulationsandpoliciesofboththeemployerandtheCWEprogram;

 completeallassignmentsassociatedwiththeCWESeminar.

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B. TheEmployeragreesto:

 provideaworkbasedlearningexperienceforthestudentwhichmeetsthelearningoutcomes;

 designateanindividual

astheSupervisortoorient,train,monitor,andevaluatethestudent,andtoserveasaliaison

betweentheemployerandcollege;

 hostthestudentforatleasttheminimumnumberofhoursspecifiedonfront;

 provideworker’scompensationinsurancecoverageandpayasalarywhichisconsistentwith

theemployer’s

practicesandpoliciesforpaidpositions;

 involvethestudentwithworkbasedlearningwithoutregardtoage,race,sexnationalorigin,religion,disability,

color,parentalstatus,ormaritalstatus;

 beincompliancewithOSHAregulationsandorientstudenttocompanysafetypolicies;

 notifytheCWE

instructorortheCWEOfficeimmediatelyofanychangeinthestudent’sjobdutiesand/orwork

supervisor;

 providefeedbacktothestudentontheirworkperformancethroughouttheterm;

 evaluatethestudentattheendofthetermonaformprovidedbytheCWEinstructor;

 reservethe

righttodischargethestudentforjustcausewithproperconsultationwiththeCWEinstructororthe

CWEOffice;

 assumeallliabilitiesassociatedwithhostingthestudent;

 defendandindemnifyCollegeandtheCollege’sagents,employeesandvolunteersagainstanyclaimforproperty

damageorbodilyinjuryarising

outofhostingthestudent.

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C. TheCollegeagreesto:

 provideaCWEinstructortoassistthestudentinthedevelopmentoflearningoutcomes;

 provideaCWEinstructortomonitortheprogressofthestudentviavisitstotheworksite;

 determineagradeandawardcollegecreditforsuccessfuljobperformanceandcompletionofrelatedassignments;

 providerelatedclassroominstructioninthestudent’sfieldofstudy;

 notifytheemployerifthestudentwithdrawsfromtheCWEprogramand/orthecollege;

 provideworker’scompensationinsurancecoveragefornon ‐paidpositions.

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Bysigningbelowtheemployer,

student,andtheCWEinstructoratClackamasCommunityCollegeagreetothetermsand

conditions.

StudentSignature: Date: _____________

SiteSupervisorSignature:________________________________________________________Date: _____________

CWEInstructorSignature:________________________________________________________Date: _____________

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