Fillable Learning Agreement Directions (California State University, Fullerton)

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Learning Agreement Directions (California State University, Fullerton)

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Learning Agreement Directions
(This page is designed to provide directions for completing the Learning Agreement (formerly the Learning Contract)
Directions for Students
• Complete all demographic information on the form.
• Be sure to complete the Instructor and Agency Information.
• Thoroughly discuss the assigned activities and skills that you wish to develop, and complete
the Learning Agreement in collaboration with your fieldwork supervisor.
• Look at the Skills Classification List included in your packet; consider which skills you
believe you will work on during the semester.
• Both the student and the fieldwork supervisor must sign the completed Learning Agreement.
Keep a copy for your own record.
• Email the completed Learning Agreement to your fieldwork seminar instructor within the
second week of instruction or as directed. Be sure to sign (type your name) and date the
form.
• Your instructor will collect and review the duties/skills for appropriateness and sign
the agreement. Keep the original in a safe place.
Directions for Fieldwork Seminar Instructors
• Discuss the Learning Agreement in your seminar class and ask students to return the
agreement to you by the second week of instruction. Ask your student to email the signed
Learned Agreement (in a fill-able pdf file).
• Review the Learning Agreement to verify that the activities and skills are appropriate and
alert the student if the agreement is not acceptable. Sign the back of the form only if it is
acceptable and keep the original until the end of the semester.
• Submit all Fieldwork paperwork (Learning Agreements, Hourly Log, Learning
Agreement– Participation Guidelines, Evaluation form, etc.) via Dropbox after posting
grades. Instructions will be provided each semester.
Directions for Agency Supervisors
• Thoroughly discuss the assigned activities and skills to be developed with the student.
• Ask your intern what he/she would like to learn at your agency.
• Complete and sign the Learning Agreement with the student (Your typed signature is okay).
• Have the student return the Learning Agreement to his/her fieldwork instructor in a timely
manner (usually within the first few weeks of the semester).
• Keep a copy of the Learning Agreement for your files.
• Review the Learning Agreement throughout the semester to verify the student’s
progress. Changes to the agreement can be made as needed.
• Be sure to turn in any paperwork to the students at the end of the semester or when they
terminate their internship.
Revised 02/21
The Department of Human Services appreciates your participation in providing a very integral component of
our students’ learning. The work that our students engage in at your agency is an extension of their overall
learning experience as a Human Services Major.
The purpose of this agreement is to formalize the requirements for the Human Services students serving at
your Fieldwork Placement organization. The Learning Agreement is the cornerstone of the practical
experience for our students. It sets the stage for what happens during the fieldwork placement, from a
practice perspective, by providing a guide for the student, the agency-based supervisor, and the Fieldwork
Seminar Instructor. Activities to be performed by the student are to be specified in the space provided.
Activities then lead to skill areas to be learned while doing the specified tasks. These skills can be specific to
the content of the activities, can be personal to the student or can be any combination of the two areas. There
may be skills that are not listed on the Skills Classification List that the student and agency-based supervisor
believe are important for the student to learn over the course of the semester.
The student agrees to perform the mutually agreed upon assignments within the agency for hours per
week during the current semester in partial fulfillment of requirements for practicum/internship field experience
in the Human Services curriculum.
Pursuant to our accreditation standards and goals of our department, direct supervision must include
one-hour per week whereby the evaluating supervisor spends time with students allowing them to
reflect on their duties, the clients, and their feelings as they participate in the fieldwork experience. Also,
students should discuss how the material they are learning in their courses applies to their experience at
the fieldwork site. Direct supervision of this nature may be done either individually or in a group. In
cases where the supervisor works alongside the intern, as long as the above experiences outlined occur
for an hour per week, then the standard of direct supervision has been met. Merely observing and giving
duties to the intern does not suffice; reflection that focuses on knowledge and skill development
appropriate to the agency is a mandatory aspect of supervision for interns.
Student and Fieldwork Seminar Information
Student Name:
Semester & Year:
Course: (Circle One) 396 495 496
490
Instructor's Name:
Instructor Phone No: Instructor Email:
Agency Information
Agency Name:
Program Name:
Agency Address:
Supervisor Name & Title:
Supervisor Phone: Email:
Does this agency require you to remain a second semester?
Yes
No If yes, make sure that you will be able to fulfill their request, otherwise choosing
another placement may be more appropriate.
LEARNING AGREEMENT
Human Services
To Be Completed by Supervisor & Student (Be detailed)
ACTIVITIES/ASSIGNMENTS SKILLS/LEARNING OBJECTIVES
This agreement has been read, discussed, and additions have been made by the student, Supervisor, and the
Fieldwork Seminar Instructor. All Parties agree to this agreement. It is the student’s responsibility to
provide a copy of this agreement to the agency supervisor, the fieldwork instructor, and to keep a copy
for his/her records.
Student Date
Agency-Based Supervisor Date
Fieldwork Seminar Instructor Date
Skills Classification List
(This list is provided as an example of skills that may be utilized
in the students Learning Agreement. You may add additional skills as needed.)
The student will learn to deal with crisis.
The student will learn to be flexible
The student will learn problem-solving skills.
The student will learn critical thinking skills.
The student will learn active listening skills.
The student will learn to be reliable.
The student will learn clear and concise writing.
The student will learn organization skills.
The student will learn computer skills.
The student will learn interpersonal skills.
The student will learn to write and use case notes.
The student will learn conflict resolution skills.
The student will learn to write and use process recordings.
The student will learn assessment skills.
The student will learn to identify dangerous/crisis situations.
The student will learn to intervene in dangerous/crisis situations.
The student will develop an awareness of gender/ethnic/and sexual orientation issues.
The student will develop sensitivity to gender/ethnic/and sexual orientation issues.
The student will learn the political and organizational system.
The student will learn about the communities the agency serves.
The student will learn community resources that are available.
The student will appropriate community resources for clients.
The student will learn to access appropriate client resources.
The student will gain knowledge of the population being served.
The student will gain knowledge of the issues being addressed.
The student will learn the importance of a professional appearance.
The student will develop a professional demeanor.
The student will learn to separate issues of self and client.
The student will learn to take initiative.
The student will learn to be self-motivated.
The student will learn when to ask for direction.
The student will learn how to take direction.
The student will learn how to deal with authority.
The student will learn to leave the job behind after work.
The student will learn to be prepared.
The student will learn realistic expectations.
The student will learn to assume responsibility for acquiring knowledge.
The student will develop a high tolerance for ambiguity.
The student will be able to identify his/her own professional work ethic.
The student will learn to develop public speaking skills.
The student will learn to increase verbalization with the specified client population
The student will learn to increase verbalization with coworkers.
The student will learn to be assertive.
The student will learn to collaborate.
The student will learn agency policies and procedures.
The student will learn to use supervision wisely.
The student will learn to learn to work within the agency policies and procedures.
The student will learn to increase verbalization with coworkers.
The student will learn to be assertive.
The student will learn to collaborate.
The student will learn agency policies and procedures.
The student will learn to use supervision wisely.
The student will learn to learn to work within the agency policies and procedures.
Revised 02/21
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Learning Agreement Directions (California State University, Fullerton)

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Completed 7 April 2021

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