Cooperative Education
Position Description
Please complete this form, sign, date and mail to:
Robert A. Henderson, Director of Cooperative Education, Manchester Community College, Great Path, MS #8, P.O. Box 1046, Manchester, CT 06045-1046
Email: rhenderson@manchestercc.edu Phone: 860-512-3312 Fax: 860-512-3371
SITE INFORMATION
Company/Agency/Organization Name Date
Mailing Address
City State Zip
Contact Person Name/Title Department
Phone Number Fax Number Email
Supervisor’s Name/Title Department
Phone Number Fax Number Email
STUDENT AND POSITION INFORMATION
Student Name Start Date/End Date
Student Position/Title
Days Per Week Hours Per Week Hourly Wage or Weekly Salary
Description of Responsibilities
REQUIRED
Supervisor’s Signature and Title Date
Continuing Notice of Nondiscrimination
Manchester Community College does not discriminate on the basis of race, color, religious
creed, age, gender, gender identity or expression, national origin, marital status, ancestry,
present or past history of intellectual disability, learning disability or physical disability, veteran
status, sexual orientation, genetic information or criminal record.
The following person has been designated to handle inquiries regarding the non-discrimi-
nation policies: Debra Freund, Chief Diversity Officer, Manchester Community College, Great
Path, P. O. Box 1046, Manchester, CT 06045-1046, SSC L277. Manchester Community College
is an Affirmative Action/Equal Opportunity Employer and strongly encourages the applications
of women, minorities, persons with disabilities, and veterans.
Continuando con el Aviso Anti-Discriminatorio
Manchester Community College no discrimina por motivos de raza, color, religión, credo, edad,
sexo, nacionalidad, identidad de género o expresión, origen nacional, estado civil, ascendencia,
historial presente o pasada de discapacidad intelectual, discapacidad de aprendizaje o disca-
pacidad física, estatus de veterano, orientación sexual, información genética o antecedentes
penales.
La siguiente persona ha sido designada para manejar consultas relacionadas a nuestra póliza
anti-discriminatoria: Debra Freund, Directora de Diversidad en Manchester Community College,
Great Path, P. O. Box 1046, Manchester, CT 06045-1046; SSC L277. Manchester Community Col-
lege está bajo el plan de Acción Afirmativa / Empleador de Igualdad de Oportunidades y alienta
encarecidamente las aplicaciones de mujeres, minorías, personas con discapacidad y veteranos.
www.manchestercc.edu/coop
December 2017/PR
