ࡱ> UWVq` bjbjqPqP 69::{8$T1^ (  +'-'-'-'1^'+0$2h50{# {#{#0 0%%%{#v  +'%{#+'%%% R _7#%/&001%5$5%5%| 2!^%!L! 00I%j 1{#{#{#{#  GROSSMONT-CUYAMACA COMMUNITY COLLEGE DISTRICT COMMUNITY SERVICE LEARNING/WORK EXPERIENCE AGREEMENT CUYAMACA COLLEGE GROSSMONT COLLEGE 900 Rancho San Diego Parkway 8800 Grossmont College Drive El Cajon, CA 92020 El Cajon, CA 92020 (619) 660-4000 (619) 644-7000 CHECK ONE BOX ONLY:  FORMCHECKBOX  Community Service Learning Students provide service to a community-based organization or school that meets a predetermined public need and relates to college coursework or career goals.  FORMCHECKBOX  Work Experience Students work in a private or public organization to gain professional skills related to college curriculum and/or their desired career.  FORMCHECKBOX  ROP Student - All parties participating in this agreement with an ROP student have a clear understanding of this program and are willing to participate according to the Title 5 California Administrative Code Guidelines Sections 10080 through 10111. Instructors NameSubjectNumberSection #UnitsSemester/Year  Students Name Cooperating Agency Date 1. The Cooperating Agency agrees to provide the student an opportunity to learn and perform within the framework of its operation without regard to race, age, color, national origin, sex (including sexual harassment) or handicap (including disability). 2. For purposes of qualifying for college credit the Cooperating Agency agrees to provide: a. A verification of the hours worked per week for the semester. b. A rating of the student's performance on the job. (form provided) c. The Cooperating Agency reserves the right to release any student during the semester. Should this occur, the College will be notified immediately. 3. The 51Ƶ District will furnish commercial general liability and workers compensation insurance coverage for the students while participating in the Work Experience Program and actually working for the Cooperating Agency. 4. The College may drop a student for failure to meet minimum scholastic or behavioral standards. The Cooperating Agency will be notified immediately should this occur. 5. The College staff will meet at least twice a semester with the Cooperating Agencies and with the students at the work site. 6. Students working full-time, who desire credit for a portion of their regular work week, should contact the appropriate administrator for special clearance. Agency verification of extraordinary assignment and training will be required. 03-0831-002 PE20.F1 51Ƶ District Community Service Learning/Work Experience Agreement page 2 HOLD HARMLESS AGREEMENTS The District shall agree to defend, indemnify, protect, and hold harmless the Cooperating Agency, its officers, agents, and employees against any and all losses, injuries, claims, actions, judgments, and liens which arise from or are connected with the acts or omissions of the District, its officers, agents, and employees. The Cooperating Agency shall agree to indemnify, protect, and hold harmless the District, its officers, agents, and employees against any and all losses, injuries, claims, actions, judgments, and liens which arise from or are connected with the acts or omissions of the Agency, its officers, agents, and employees. TRAINING PLAN All training experiences shall be in accordance with the student's training plan which includes occupational goals and objectives and duration of training for attainment of each competency. The student is required to state occupational goals and job objectives in the space below. They should be SPECIFIC, ATTAINABLE, and MEASURABLE, and may be revised at anytime during the semester. The final goals and objectives as agreed upon by the student and instructor are attached to this document. PLEASE PRINT It is agreed that Cooperating Agency Contact Person Phone Number Address shall assign Name of Student for purposes of providing work experience as part of the student's college training. The student shall be assigned for an average of hours per week. In order to receive credit the students must successfully complete the assignment as agreed. STUDENT Signature Date COOPERATING AGENCY Signature Date INSTRUCTOR Signature Date DISTRIBUTION BY INSTRUCTOR: White copy - College Pink copy Cooperating Agency Yellow copy - Student 03-0831-002W PE20.F1   /01g % ' ( 6 7 8 9 S      ںڧyڧeںڧQں'jh:h:OJQJUaJ'jth:h:OJQJUaJh>@CJ OJQJ'jh:h:OJQJUaJh:h:5OJQJaJ$jh:h:5OJQJUaJh>5@CJOJQJ$hj\h>@CJOJQJmHsHh>@CJOJQJh>h>@OJQJh>5@OJQJ01ghi    & ' $ 0!*$^`a$ 0!*$^` 0!*$ $ 0!*$a$ $ *$a${ $ 0$*$Ifa$ $ 0*$a$$ 0!*$^`a$$ 0@ ,*$^`a$ F4444$ 0$*$Ifa$kd\$$Iflֈ h:#* b04 lal 4kd/$$Iflֈ h:#* b04 lal$ 0$*$Ifa$  , - . / , -  h0d*$^`0 hd*$ hhd*$^h`$ 0d*$a$$ 0$d*$a$$ 0(#$0*d*$a$ $ 0*$a$     b n %EG_x%&FGacɻ攂 h>5h>5@CJOJQJh>$h06hxl@CJOJQJ^JaJhJ6@CJOJQJ^JaJh]~@CJOJQJaJ h]~h]~@CJOJQJaJh\@CJOJQJh>@CJOJQJh>>*@CJOJQJ3UVEFG`a$ hd*$a$ $ )d*$a$gdxl hhd*$^h` hd*$wx#$'$ h|)d*$a$ $ d*$a$$ h|)d*$a$ $ h*$a$ hd*$<$a$$ hd*$a$'DEHQRduv$ h (#@d*$a$$ h )@Bd*$a$$ h!hd*$^h`a$ $ d*$a$$ h|)d*$a$$ h!d*$a$$ !d*$a$89:Fbdeopqrxyz{¶|iVJhG\@CJOJQJ$h06h>@CJOJQJ^JaJ$h06hG\@CJOJQJ^JaJhJ6@CJOJQJ^JaJh:h>@CJOJQJh]~@CJOJQJh:h:@CJOJQJh:@CJOJQJh>@CJOJQJh>5@CJOJQJh>>*@CJOJQJh\@CJOJQJh>@CJOJQJderz{}ttttr $ )d*$a$$ )d*$a$gd\$ h (#@d*$a$$ h )@Bd*$a$$ h (#)@Bd*$a$$ h )@Bd*$a$$ h d*$a$ {|~hG\@CJOJQJhjhU}~ $ )d*$a$d 4....()()))()00P8$BP/ =!"#$K%K tDeCheck1tDeCheck1tDeCheck1$$Ifl!vh5 55555b#v #v#v#vb:V l05 555b4al$$Ifl!vh5 55555b#v #v#v#vb:V l05 555b4al>L@L Normal1$ CJOJQJ_HkHmH sH tH b@b Heading 1"$$ 0*d*$@&a$5@CJOJQJZ@Z Heading 2$$ *$@&a$5@CJOJQJDA@D Default Paragraph FontVi@V  Table Normal :V 44 la (k(No List 4+4  Endnote Text>*> Endnote ReferenceH*66  Footnote Text@&!@ Footnote ReferenceH*,O1, Document 86OA6 Document 4 56CJ,OQ, Document 6,Oa, Document 5HOqH Document 2CJOJQJkHmH sH u,O, Document 7.O. Bibliogrphy.O. Right Par 1.O. Right Par 2HOH Document 3CJOJQJkHmH sH u.O. Right Par 3.O. Right Par 4.O. Right Par 5.O. Right Par 6.O. Right Par 7.O!. Right Par 8dO2d Document 1#$$*$1$ 0 CJOJQJ_HkHmH sH tH (OA( Doc InitFOQF Tech InitCJOJQJkHmH sH u.Oa. Technical 5.Oq. Technical 6JOJ Technical 2CJOJQJkHmH sH uJOJ Technical 3CJOJQJkHmH sH u.O. Technical 4JOJ Technical 1CJOJQJkHmH sH u.O. Technical 7.O. Technical 8NN TOC 1). $ 0*$]^`0JJ TOC 2%/ $ 0*$]^`0JJ TOC 3%0 $ p0*$]^p`0JJ TOC 4%1 $ @ 0*$]^@ `0JJ TOC 5%2 $ 0*$]^`0BB TOC 63 $0*$^`0:: TOC 740*$^`0BB TOC 85 $0*$^`0BB TOC 96 $ 0*$^`0N N Index 1%7 $ `*$]^``N N Index 2%8 $ 0*$]^`0>.>  TOA Heading 9*$ $*"* Caption::O: _Equation CaptionnC@n Body Text Indent$<$ hhd*$^ha$@CJOJQJHH ]~ Balloon Text=CJOJQJ^JaJ801ghi&',-./,-UV  E F G ` a wx#$'DEHQRduvderz{}~000000000000000000000000 0 0 0 0 0 0 00 0 0 0 0 0 0 0000000000000000000000000000000000000000<00<0<0<000000000000000000000000000000000000I0I0I0I0I0I0I0I0   {  '}'7G$G$G$Check1(8 9 9!9 J9,>9|)9#9494L94>js{{rzV*urn:schemas-microsoft-com:office:smarttagsplacehttp://www.5iantlavalamp.com/;*urn:schemas-microsoft-com:office:smarttagsaddress= *urn:schemas-microsoft-com:office:smarttags PlaceName=*urn:schemas-microsoft-com:office:smarttags PlaceType:*urn:schemas-microsoft-com:office:smarttagsStreet I  {{}}~~YSXwz{{}}~~3333/bn% 89:Fz{{}}~~xljg006g>jG8ٲ6]0:4$'<B&>z1J6\0{}@\\c7\clib8Ne02:winspoolHP LaserJet 4100 PCL 6\\c7\clib8? odXXLetter.HP LaserJet 4100 PCL 62xeKkTAtwf2,|x}LL(d(0pj;ERqBq#\%>kw2TQ]Ne ˨VJmT$i-X[&J͸D`T#<@πo[up8xv#3` Ǧ]I.g`GZm%6QlS'k𗴿  BVhvMn(t֎Na8t |a9Xr:t"Cz\|mAȎ9tg @?cNH^d<KW/\muL4ZƹZ;cgm_B!k-`9{fuwM&|98 k\\c7\clib8? odXXLetter.HP LaserJet 4100 PCL 62xeKkTAtwf2,|x}LL(d(0pj;ERqBq#\%>kw2TQ]Ne ˨VJmT$i-X[&J͸D`T#<@πo[up8xv#3` Ǧ]I.g`GZm%6QlS'k𗴿  BVhvMn(t֎Na8t |a9Xr:t"Cz\|mAȎ9tg @?cNH^d<KW/\muL4ZƹZ;cgm_B!k-`9{fuwM&|98 k$w@@UnknownGz Times New Roman5Symbol3& z ArialY CG TimesTimes New RomanO1 CourierCourier New5& zaTahoma"9)Hfv Vcy !)P4dss2)PHX?jQ2/Form, Work Experience Contract Agreement [form]GCCCDGCCCDOh+'0   0< \ h t 0Form, Work Experience Contract Agreement [form]GCCCD Normal.dotGCCCD4Microsoft Office Word@d@Lsy@TH@LO7՜.+,D՜.+,p, px  GCCCDs 0Form, Work Experience Contract Agreement [form] TitleH`_AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_PreviousAdHocReviewCycleID_ReviewingToolsShownOnce-'PDistrict Operating Procedure PE20 - Coopeative Career Education/Work ExperiencePaula.Tillery@gcccd.netPaula TillerybP  !"#$&'()*+,-./0123456789:;<=>?ABCDEFGIJKLMNORRoot Entry F_7TData 1Table%5WordDocument69SummaryInformation(@DocumentSummaryInformation8HCompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89qRoot Entry FTdJZData 1Table%5WordDocument69  !"#$&'()*+,-./0123456789:;<=>?ABCDEFGYX _AdHocReviewCycleID_EmailSubject _AuthorEmail_AuthorEmailDisplayName_PreviousAdHocReviewCycleID_ReviewingToolsShownOnceSummaryInformation(@DocumentSummaryInformation8@CompObjq  FMicrosoft Office Word Document MSWordDocWord.Document.89q՜.+,D՜.+,p, px  GCCCDs 0Form, Work Experience Contract Agreement [form] Title