3. Coast District Work Experience Education (WEE) Company/Organization Agreement

STUDENT INFORMATION

*First Name:

*Last Name:

*Student ID:

*Student Email:

COMPANY/ORGANIZATION INFORMATION

Please provide some details on where you will be completing your work experience placement.

*Company Name:

*Company Website/URL:

*Company Address:

Worksite Address:
(If different from the company's primary address)

*Site Supervisor First Name:

*Site Supervisor Last Name:

*Site Supervisor Phone:

*Site Supervisor Email:

If the person approving the student's learning objectives is different than their site supervisor, please provide their information here:

Objective Approver Name:

Objective Approver Phone:

Objective Approver Email:

FACULTY INFORMATION

Course Instructor

Course Instructor Email

If you have a faculty mentor (other than your course instructor) for the course you are taking, please provide their information here.

Faculty Mentor Name:

Faculty Mentor Email:

POSITION INFORMATION

EMPLOYMENT | INTERNSHIP | VOLUNTEER

Please provide some details on how you will be completing your work experience placement.

WEE Credit & Hour Requirements:

0.5 unit - 27 Hours Unpaid or Paid
1 unit - 54 Hours Unpaid or Paid
1.5 units – 81 Hours Unpaid or Paid
2 units - 108 Hours Unpaid or Paid
2.5 units – 135 Hours Unpaid or Paid
3 units - 162 Hours Unpaid or Paid
3.5 units – 189 Hours Unpaid or Paid
4 units - 216 Hours Unpaid or Paid

WEE Hours Must Be Completed Within Course Dates

*Confirm the number of Work Experience hours/units you will be enrolling for this term:

*Type of work:

Paid

Unpaid

*Position Title:

How long have you worked with this company?
Note: If you are just starting work for this company, please indicate "0".

How long have you worked in this position?
Note: If you are just starting work for this company, please indicate "0".

*Main Duties/Assigned Responsibilities:

*Where will your Work Experience Education job/internship/volunteer position take place?

Both working onsite at the company AND remotely from home

Working onsite at the company

Working remotely from home

*Work Schedule:
Schedule can vary each week - Provide a general, anticipated weekly schedule. Must meet the minimum WEE requirements required by units enrolled.
Select the days you typically have a shift, and then enter start and end times as 00:00 AM/PM.

Sunday

Yes

No

Start Time:

End Time:

Monday

Yes

No

Start Time:

End Time:

Tuesday

Yes

No

Start Time:

End Time:

Wednesday

Yes

No

Start Time:

End Time:

Thursday

Yes

No

Start Time:

End Time:

Friday

Yes

No

Start Time:

End Time:

Saturday

Yes

No

Start Time:

End Time:

For this work experience, will you:

Please provide some details on specific activities you will be completing during your work experience placement.

*Operate a company vehicle?

Yes

No

*Work with hazardous materials?

Yes

No

*Operate heavy equipment?
(ie. Forklift, Bulldozer, Press Machinery, etc.)

Yes

No

*Work with minors?

Yes

No

*Work in a private residence?

Yes

No

*If you answered yes to any of the questions above, please explain those duties.

OBJECTIVES

One of the prime requirements of the WEE course is that students develop new or expanded job-oriented learning objectives beyond those experienced during previous employment or internships. This is an opportunity for students to integrate or demonstrate the knowledge and skills developed at college into a workplace environment. It is essential that the instructor assists and guides student(s) in developing measurable job-oriented learning objectives that provide educational value to the students.

How to Write Learning and Achievement Objectives.

You will profit most from your Work Experience by developing a set of meaningful and attainable objectives.

As you develop your objectives, consider and identify:

Your present level of development
Your area of interest
Activities expected to be done
Challenges you are likely to encounter
Opportunities you will have for self-realization

For more information about writing your learning objectives, please see the Work Experience Education Handbook. *LINK TO ANCHOR WITHIN THE HANDBOOK PDF TO OBJECTIVES SECTION*

Please list your learning objectives. Provide a minimum of 4 objectives. You may include up to 8 different objectives.

*Objective 1:

*Objective 2:

*Objective 3:

*Objective 4:

Check to include additional learning objectives

Objective 5:

Objective 6:

Objective 7:

Objective 8:

STUDENT SIGNATURE

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