Work-Based Learning Training Agreement (Paid/Unpaid)

Tri-party agreement for a work-based learning placement that clarifies student, employer, parent/guardian, and school responsibilities for paid or unpaid experiences.

Submission Notice and Consent

• Placement type
• Consent to collect and use the information in this form for work-based learning placement administration
• Additional notes for the school coordinator

Student Information

• Student full name
• Student ID
• Grade level
• School name
• Program or career pathway
• Student email

Placement Details

• Placement title or role
• Employer / host organization name
• Worksite address
• Placement start date
• Placement end date
• Weekly schedule
• Expected hours per week
• Worksite supervisor name

Paid or Unpaid Terms

• Hourly wage
  Required for paid placements only.
• Pay frequency
• Unpaid placement acknowledgement
  For unpaid placements, confirm that the student understands the placement is unpaid and is for educational purposes.

Responsibilities and Safety Expectations

• Student responsibilities
• Employer responsibilities
• School responsibilities
• Required safety training completed before the placement begins
• Transportation arrangement

Parent or Guardian Acknowledgement

• Parent or guardian name
• Parent or guardian email
• Parent or guardian phone
• Acknowledgement and consent

Signatures and Approval

• Student signature
• Parent or guardian signature
• Employer signature
• School coordinator signature
• Approval date