Fillable University of Guelph - Letter to Placement Employers

Fill Online, Printable, Fillable, Blank University of Guelph - Letter to Placement Employers Form

Use Fill to complete blank online UNIVERSITY OF GUELPH pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

University of Guelph - Letter to Placement Employers

On average this form takes 2 minutes to complete

The University of Guelph - Letter to Placement Employers form is 2 pages long and contains:

  • 1 signature
  • 0 check-boxes
  • 4 other fields

Country of origin: CANADA
File type: PDF

Canada forms for University of Guelph

BROWSE UNIVERSITY OF GUELPH FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
October 2018 Page 1 of 2
Letter to Placement Employers
Process for Workplace Insurance for Postsecondary Students on Unpaid Work
Placements
The Ministry of Training, Colleges and Universities (MTCU), has released revised Guidelines for
Workplace Insurance for Postsecondary Students of Publicly Assisted Institutions on Unpaid
Work Placements that detail the process for students on work placements who are enrolled in
an approved Ontario university program.
The Government of Ontario, through MTCU, pays the Workplace Safety and Insurance Board
(WSIB) for the cost of benefits provided to Student Trainees enrolled in an approved program at
the University of Guelph and participating in unpaid work placements with employers who are
either compulsorily covered or have voluntarily applied to have WSIB coverage.
MTCU also covers the cost of private insurance with Chubb Insurance (formerly ACE-INA
Insurance) for Student Trainees enrolled in an approved program at the University of Guelph
and participating in unpaid work placements with employers that are not required to have
compulsory coverage under the Workplace Safety and Insurance Act or unpaid placements out
of province.
Placement Employers and Training Agencies (universities) are not required to complete and
sign the online Postsecondary Student Unpaid Work Placement Workplace Insurance Claim
Form for each placement that is part of the student’s program of study in order to be eligible for
WSIB coverage. Instead, this form only needs to be completed when submitting a claim
resulting from an on-the-job injury/disease. Please note that universities will be required to enter
their MTCU-issued Firm Number in order to complete the online claim form; the Placement
Employer’s WSIB is not impacted by claims.
The MTCU Guidelines for Workplace Insurance for Postsecondary Students of Publicly Assisted
Institutions on Unpaid Work Placements and the claim form are posted on the Ministry’s public
website at: http://www.tcu.gov.on.ca/pepg/publications/placement.html
Please note that all WSIB or Chubb Insurance procedures must be followed in the event of an
injury/disease.
Declaration
By signature of an authorized representative, the Placement Employer hereby agrees to the
following:
That it will immediately report to the University any workplace injury or disease involving a
student on an unpaid work placement. Where the Placement Employer is covered by the WSIB,
the Placement Employer will comply with all WSIB reporting procedures. If the Placement
Employer is not covered by the WSIB, then it will comply with the Chubb reporting procedures
found in the MTCU Guidelines for Workplace Insurance for Postsecondary Students of Publicly
Assisted Institutions on Unpaid Work Placements.
Within three days of a work related accident, Placement Employers that are covered under the
Workplace Safety and Insurance Act will provide to the University the incident report, as well as
October 2018 Page 2 of 2
any other necessary information related to the accident, along with a completed Letter of
Authorization to Represent the Placement Employer. The University will complete the Form 7.
The Placement Employer agrees that it will provide the Student Trainee with health and safety
training, or verify that they have completed the appropriate health and safety training, and take
appropriate precautions to ensure that the Student Trainee is supervised in order to protect the
Student Trainee from health and safety hazards that may be encountered at the placement
organization.
The Placement Employer agrees to provide written confirmation that the Student Trainee has
received the appropriate health and safety training.
In the event of a claim, the Placement Employer agrees that it will review the Student Trainee’s
restrictions and, where possible, modify the program as required in order to accommodate the
Student Trainee to facilitate return to the program.
Organization:
Date:
Title:
Signature:
Employer’s organization is covered under the Workplace Safety & Insurance Board?
A signed copy of this document is to be returned to the University of Guelph placement
coordinator, prior to the commencement of the work/education placement, and a copy is to be
kept by the Placement Employer.
click to sign
signature
click to edit
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

University of Guelph - Letter to Placement Employers

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 27 May 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document