Work Based Learning - EdZonempaaa/Conference/S10/S3B_WrkBased_Presentati… · Work-Based Learning Count Day Time Sheet (Fall) June 2009 WORK-BASED LEARNING COUNT DAY TIME SHEET Wednesday,

Work Based Learning MPAAA Spring 2010

Debbie Lynch WBL Coordinator

Williamston High School

Ellen BehmPupil Accounting Auditor

Ingham ISD

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Session Agenda

Overview of WBL

High School Program Example

Auditing WBL Programs

Questions

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WBL Overview

Two Main Categories:

1. Non-CTE Work-Based Learning Experiences

2. State Approved CTE Work-Based Learning

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WBL Overview

Non-CTE Work-Based Learning Placements

1. Paid or Unpaid WB Learning (Out-of-District)

2. WB Learning for Pupils with Disabilities

3. In-District Placement with Transition Services

Plan

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WBL Overview

State Approved CTE Work-Based Learning Placements

1. Paid Work-Based Learning Exp. (Capstone) State-

Approved CTE Programs

2. Unpaid WB Learning Exp. State-Approved CTE

Programs

3. In-District Unpaid WBL State-Approved CTE

4. Unpaid Training State-Approved CTE Less-Than-

Class-Size Programs

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WBL Overview

In-District Placements

Must Be:1. Directly related to postsecondary career and

employment goals in pupil’s transition services plan

OR

2. Placement for related State-Approved CTE Program

(Must identify PSN for the CTE program)

An In-district placement is not an experiential

learning course

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WBL Overview

Requirements:

•Training Plan

•Training Agreement

•Site visits every 9 weeks (30 days SE)

•Safety Instruction

•Attendance records at work site

•Credit towards diploma

•Not exceed 50% of FTE

•Alignment with career pathway in EDP & Related Instruction

•Workers Compensations and Liability Insurance

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High School Program

Debbie Lynch

WBL Coordinator

Williamston High School

[email protected]

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Folders for Students

Guidelines

Calendar

Time sheets

Assignments

Handouts

Meeting handout

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WBL Binder

Tally Sheet

Alphabetize each student

Binders are portable

Input grades directly from binder

Easy for auditor to check

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Guidelines Explains WBL experience

Etiquette

WBL Benefits to School, Employer and Student

Guidelines of program, Ex. Minimum hours, timesheets, etc.

Sexual Harassment

Verification Form signed by both student and parent/guardian

Sample Guidelines

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Training Agreement & Plan

Training Agreement & Training Plan obtained from the michigan.gov website.

Students receive points for turning in Training Agreement & Plan.

Sample Training Agreement Sample Training Plan

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Safety Training Plan

Students must speak to employer regarding safety training and sign and return form.

Students receive points for turning in Safety Training Plan.

Forces employers to teach safety training and awarding points assures I will get the form back quickly.

Sample Safety Training Plan

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Calendar

I type up a calendar for each trimester with due dates for time sheets and assignments.

I add holidays, in-service days, exam schedule and other days that could affect their employment or times they have to come to school.

Sample Calendar

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Time Sheets

Time sheets are stapled and included in folder with dates for entire trimester.

Due each week. Students turn time sheets into a folder in the Guidance Office.

Students get points for completing time sheets each week.

Sample Time Sheet Count Day Time Sheet

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Assignments

Assignments are due on the last day of the month throughout the trimester.

Employability type assignmentsGetting to know your work placeYouth Employment Standards ActBusiness EtiquetteEthics in the work placeOccupational SkillsCustomer Service

Sample Assignments

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Site Visitation Log

Type up Site Visitation log after Trimester begins.

Log has student’s employer and supervisor name so I only have to take log with me on visits.

Log has a place for Employer to sign for proof I visited site.

Sample Visitation Log

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Ellen Behm

Pupil Accounting Auditor

Ingham Intermediate School District

[email protected]

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Auditing WBL Programs* A violation of this item should be reported as a specific finding with an FTE adjustment for all programs. Other issues should be reported as general findings.

1. Verify that the district had a written training agreement in place on the count date which included:

(a) Student learner’s personal information: name, home address, telephone number, date of birth and emergency contact information

(b) Employer’s name, address, telephone and contact person

(c) Employer, school and student learner’s responsibilities*

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Training Agreement continued:

(d) Dates of Safety Instruction*

(e) Beginning and end dates of agreement*

(f) Daily hours to be worked, including beginning and ending times*

(g) Verification of workers disability compensation and general liability insurance.*

(h) Signatures of the principal/or designee, certificated coordinator, student learner, parent/guardian, and employer.*

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2. Verify that the district had a written training plan in place on the count date which included:

(a) For unpaid learners, new specific skills need to be listed for each 45-hour placement.*

(b) Identification of related academic course(s) instruction (non-CTE and non-Special Education only) where pupil was previously or is currently enrolled.

(c) Signatures of the principal/or designee, certificated coordinator, student learner, parent/guardian, and employer. If the training plan and training agreement are combined, one set of signatures is sufficient.*

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3. The employer or coordinator maintained attendance records (i.e., time sheet signed by the employer).*

4. Work hours did not generate more than one-half of the pupil’s FTE.*

5. The experience must be provided for high school credit.*

6. Certified teacher/coordinator who is employed by the district monitored the pupil’s work once every 9 weeks (30 calendar days for Special Education), (i.e., log with date of visit, student name, employer name, coordinator signature).*

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7. In-district/In-school placements, either:

(a) Pupils receiving special education services under a transition services plan may be placed in the district. Verify that a copy of the pupil’s transition services plan is attached to the unpaid in-district placement agreement and directly relates to the placement.* or:

(b) An in-district placement can relate to a state-approved career and technical education (CTE) program. Verify that the completed in-district placement agreement identifies the program serial number (PSN).*

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Resources

Pupil Accounting Manual/Section 5/P: www.michigan.gov/mde Offices – State Aid and School Finance ORhttp://www.michigan.gov/documents/5P-workBasedEducProg_41468_7.pdf

Pupil Auditing Manual: www.michigan.gov/mde Offices – State Aid and School Finance ORhttp://www.michigan.gov/documents/mde/2009-2010_PUPIL_AUDITING_MANUAL_315455_7.pdf

Sample Training Plans and Training Agreements: www.michigan.gov/octp “ Work Based Learning Guide for Risk Management”

Michigan Pupil Accounting and Attendance Association:www.mpaaa.org

Michigan Career and Placement Association: www.edzone.net/mcpa

Additional Handouts: 1.) WBL Program Overview and Resources2.) WBL Opportunities Chart

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Section 5P -- Pupil Accounting Manual

Signed Completed Notification Received by OCTE Time Shall be equivalent to State-Approved CTE Program No more than 4 pupils per instructor Instruction by LTCS annually authorized personnel

1. Paid or Unpaid* Work- Based Learning Experiences *Unpaid = 45 hours per specific training experience

3. In-District Unpaid Work-Based Learning Experience

4. Unpaid Training/State Approved CTE Less-Than-Class-Size (LTCS) Programs

11th-12th Vocationally Certificated Teacher or Coordinator

1. Paid or Capstone Work-Based Learning Experience

Every 9 Weeks

Unpaid = 45 hours per specific training experience Every 9

Weeks 11th-12th

Vocationally Certificated Teacher or Coordinator


1. Has successfully completed 50% of state-approved CTE program.

2. Must work minimum of 10 hours per week

3. Must attend related CTE class or capstone class minimum of 40 mins. Per week.

Every 9 Weeks

WORK-BASED LEARNING STATE-APPROVED CAREER AND TECHNICAL EDUCATION (CTE) PROGRAMS

Every 9 Weeks Unpaid = 45 hours per

specific training experience

11th-12th


11th-12th2. Unpaid WorkBased Learning Experience

Site visited by a district

employed certificated

teacher. Pupil enrolled &

assigned to special ed

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No requirement for previous or concurrent enrollment in related academic course.

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9th-12th

WORK-BASED LEARNING NON-CTE PROGRAMS

Currently or previously enrolled in related Academic Class/Course

Follow Federal and State Regulations to Employ Minors

9th-12th

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Placement must relate to the pupil's transition services plan.

Every 30 calendar

days

1

EMPLOYABILITY SKILLS AND BUSINESS ETIQUETTE

Work Based Learning Assignment #3 Topic Directions: Using at 3 sources, research and compose a report on Employability Skills and Business Etiquette. Define employability skills/business etiquette List and define individual traits of those possessing employability

skills/business etiquette (for example: punctual) Indicate the affects of employability skills/business etiquette (or lack of) in

the business world and educational environment. Give examples of real-world business situations in relationship to

employability skills/business etiquette Report Formatting Directions: Your report must be typed and formatted in the following set up: Cover page

o Assignment name o Course name (WBL) o Your name o Current date

Report pages o A minimum of 1 page o Double spaced o 1-inch margins o Times New Roman font; size 12

Resource page o List of resources used to complete paper.

*Staple your report and put in the blue folder in the Student Services office.

Work-Based Learning Count Day Time Sheet (Fall) June 2009

WORK-BASED LEARNING

COUNT DAY TIME SHEET Wednesday, September 30, 2009

Directions:

1. This form is to verify employment/work hours on COUNT DAY. 2. Complete this form for COUNT DAY only. You must also complete a weekly time

sheet for the week of September 28 – October 2. 3. If you are not scheduled to work on COUNT DAY, indicate that on the form below

and indicate the next date/time you are scheduled to work after Wednesday, September 30.

4. Your supervisor MUST sign this document. 5. Submit this document on Thursday, October 1.

WORK DAY: Wednesday, September 30, 2009 (Fall Count Day)

Student’s Name: Student’s Grade Level/Age: Grade: Age: Employer’s Name:

DAY DATE (list month and date)

WORK TIMES (list beginning and

ending times)

DAILY HOURS (list number of

total daily hours)

TASKS PERFORMED OR

REASON FOR ABSENCE

Wednesday

Sept. 30, 20089 (Fall Count Day)

I am not scheduled to work on Wednesday, September 30, 2009. My next scheduled work day & time after September 30, 2009, are

Day (Date) _________________________________________

Time _____________________________________________

PRINT CLEARLY

I certify that the above information is accurate.

_______________________________ __________________________________ Supervisor or designee Employee (Student) __________________________________ ______________________________________ Date Date

It is the policy of Owosso Public Schools that no discriminatory practices based on gender, race, religion, color, age, national origin, disability, height, weight, marital status, sexual

orientation, political affiliations and beliefs, or any other status covered by federal, state or local laws be allowed in providing instructional opportunities, programs, services, job

placement assistance, employment or in policies governing student conduct and attendance.

Work-Based Learning Training Agreement State-Approved CTE Program

District: School Year: Building: Student/Learner Information Last Name: ___________________ First Name: _____________ Middle Initial: ___ Grade (11-12 Only): _______

Home Address: _______________________________________ Telephone Number(s): _______________________

Birth Date: _________________________ Emergency Contact Information: ________________________________

School District Information

Vocationally Certificated Teacher/Coordinator: ________________________________________________________

Telephone Number(s): ___________________________ ______________________________________________

Employer Information Name of Business: Supervisor:

Address: Phone:

City: Zip:

Worker’s Disability Carrier: Policy No.: ______________________________________________

Liability Insurance Carrier: Policy No.: ______________________________________________

Placement Information

Type of Placement (check one): Paid Unpaid [If this is an unpaid work-based learning experience, specific, unduplicated skills that the pupil will be learning need to be listed on the training plan for each 45 hours of placement.

Job Title: Date Employment Begins:

Date Employment Ends:

Safety instruction has been provided by the school or employer: ______ Date(s) of Safety Instruction:_____________

Schedule for Site Visitation:_________________________________________________________________________

Hours to be worked: (For unpaid experience – must occur during scheduled classroom time. If not, the exception must be documented)

Mon Tue Wed Thu Fri Sat Sun

Earliest

Latest

Avg. Hrs. Per Day*: Max Hrs. Per Week**: Starting Wage (if paid):

*Cannot compute to more than ½ of the pupil’s FTE. **Work and school hours cannot exceed 48 hours per week for students under age 18

Number of credit hours to be granted: Name of Related State-Approved CTE Program: ________________________________________________________

**Program serial number (PSN) of related state-approved CTE program: _______

[**IMPORTANT: If the PSN in not filled in, it WILL result in an FTE deduction]

Training Plan IN ORDER FOR THIS TRAINING AGREEMENT TO BE VALID, A RELATED TRAINING PLAN FOR THE PUPIL BEING PLACED MUST BE ATTACHED OUTLINING THE SPECIFIC PERFORMANCE ELEMENTS/JOB SKILLS THAT THE STUDENT WILL BE LEARNING. Attached Student Responsibilities [Local district determines these responsibilities] 1. Transportation to and from the training site, for the duration of the placement, is the student’s responsibility. 2. The trainee must maintain a passing grade in the related course to pass the work experience and remain in the program. 3. Any student who will be tardy or absent from the scheduled work time must notify their employer. 4. Any student who skips school, will have the work based learning placement reviewed and may be removed from the program. 5. Should any problems arise at work or school that may affect the student’s placement, the student should notify the coordinator immediately. 6. Students are required to obtain permission from the designated vocationally certified teacher/coordinator before quitting any

work-based learning placement. 7. Students are required to complete weekly work hour reports to the coordinator. Failure to complete these required hour reports will result in the student failing the work experience. 8. Students will adhere to all safety requirements specific to this placement as identified by MI-OHSA and their supervisor. 9. Students who are absent from school are not permitted to work that day at their placement and must notify the employer. School Responsibilities [Local district determines these responsibilities] 1. The placement relates to the student’s career/education goals as outlined in their education development plan (EDP). 2. The vocationally certificated teacher/coordinator makes at least one visit, every nine weeks, to the training site. 3. The student is regularly supervised by certified staff and provided instruction in areas of skill attainment and work safety. 4. High school completion credit will be granted upon successful completion of the placement. 5. Daily attendance is recorded. 6. The program must not violate the Fair Labor Standards Act and the Youth Employment Standards Act. Employer Responsibilities [Local district determine these responsibilities] 1. The employer will provide the trainee with the broadest occupational experience in keeping with the job duties listed in the training plan and provide specific instruction on the use of any equipment or materials related to job duties. Documentation of this instruction should be maintained in the trainee’s employment file. 2. The employer will ensure the student learner’s employment activity is supervised by an experienced and qualified person (work-based mentor), and will complete trainee performance evaluations and verify attendance as required. 3. A written evaluation of student performance will be completed based on the performance elements/job skills listed on the

attached training plan. 4. The employer will provide a training site that is free of obvious hazards that could cause potential injury or harm to the student. The signature of the employer below certifies that the employment of the student learner will conform to all federal, state and local laws and regulations, including those that prohibit discrimination against any applicant or employee because of race, color, religion, national origin or ancestry, age, gender, height, weight, marital status or disability. Student’s Signature Date Parent’s Signature Date Vocationally Certificated Teacher/Coordinator Signature Date ___________________________________________________________________________________________________________________ Principal or Designee Signature Date Employer Printed Name and Signature Date NOTICE OF NONDISCRIMINATION: _______ District is in compliance with federal laws relating to nondiscrimination. It is the policy of the _______________________School District not to discriminate on the basis of race, color, national origin, gender, age, disability, height, weight or marital status in its programs, services or activities. The following person has been designated to handle inquiries regarding the nondiscrimination policies:

CUSTOMER SERVICE Work Based Learning Assignment #7

Directions: Using at least 3 sources, research and compose a short report on Customer Service.

Define customer service List and define some examples of customer service (for example: store

greeters) Indicate the affects of customer service (or lack of) in the business world

and educational environment. Give examples of real-world business situations or your personal experiences

where good/bad customer service has been displayed. Report Formatting Directions: Your report must be typed and formatted in the following set up: Cover page

o Assignment name o Course name (WBL) o Your name o Current date

Report pages o A minimum of 1 page o Double spaced o 1-inch margins o Times New Roman font; size 12

Resource page o List of resources in alphabetical order o Helpful websites: www.best-in-class.com, www.tsbj.com www.theentrepreneurialedge.com, www.tsbj.com, www.eastytraining.com

NOTE: A good resource can be an employer/boss!

EMPLOYABILITY SKILLS “Measures of Job Success”

Work Based Learning Assignment #6 The purpose of this assignment is for you to recognize that there are skills you can acquire at your job that will help you be successful in your future career. These employability skills are referred to as ‘soft’ or ‘transferable’ skills. As you complete this assignment you will:

1) Gain knowledge and understanding of 26 skills Michigan employers say are important.

2) Identify your strengths and weaknesses regarding these skills. 3) Set goals for improvement of certain skills. 4) Demonstrate that you have met your goals.

PART 1 Directions: Complete each of the following tasks.

1. Read the attached Measures of Job Success list of skills and explanations. 2. To the left of each skill, rate yourself using the following code:

1 = Proficient 2 = Average Proficiency 3 = Needs Improvement

3. Show the list to your employer. Have him/her rate your skills as above. 4. Select five skills that you and your employer agree need improvement or are of

average proficiency. Write these skills in the spaces below. 5. Write the five skills below.

Skills I need to Improve

1._______________________________ 2._______________________________ 3._______________________________ 4._______________________________ 5._______________________________

EMPLOYABILITY SKILLS / PART 2

Directions: Write a goal statement for each of the five skills you listed on Part 1 of this assignment. In other words, how do you intend to improve the skill? For example: Skill = Complete Tasks On Time. I will practice completing every task assigned to me in a timely manner. To do this I will stay focused on the task and complete it as efficiently as I am able. I expect to be proficient at this skill by Christmas. Skill 1: Skill 2: Skill 3: Skill 4: Skill 5: After writing goal statements for each skill, complete one of the following projects. This will demonstrate that you are working towards becoming proficient at the skill.

1. Record your progress by writing in a journal. Date each entry. Two entries for each skill is the minimum requirement. (Notebook paper is acceptable.)

2. Draw a timeline indicating milestones for accomplishing each skill. Use either words or pictures.

3. Have someone take photos of you at work performing each skill proficiently.

MEASURES OF JOB SUCCESS Here are the skills Michigan employers have said they’re looking for: Directions: To the left of each skill, rate yourself under the S (for student) using the following code: 1 = Proficient 2 = Average Proficiency 3 = Needs Improvement Have your employer rate you under the E (for employer) using the same code. E S ______ _______ DEPENDABLE

Trustworthy, reliable (capable of being relied on). Rely: To place or have faith or confidence.

______ _______ RESPONSIBLE

Involving personal accountability or ability to act without guidance or superior authority.

______ _______ HONEST

Not deceptive or fraudulent; genuine. Marked by or displaying integrity characterized by truth. Integrity: Steadfast adherence to a strict moral or ethical code.

______ _______ RESPECTS OTHERS

Respect: To feel or show deferential regard for; esteem. Willingness to show consideration or appreciation. Deference: Submission or courteous yielding to the opinion, wishes, or judgment of another.

______ _______ GOOD LISTENER

Good: Superior to average. Pay attention to what is being said. To hear and understand.

______ _______ FOLLOWS DIRECTIONS

Able to perform tasks and/or activities in the way described by a supervisor.

______ _______ ON TIME FOR WORK

Depending upon the employer, arriving at work, ready to work, at least 5 to 10 minutes before your shift begins.

E S ______ _______ GOOD ATTENDANCE

Good: Superior to average. Absent more than once a month is unacceptable. Once a month is a ‘trend’, as defined by employers. Miss work only when it is unavoidable. Give as much notice as possible. Never miss a day = good attendance.

______ _______ FREE FROM SUBSTANCE ABUSE

No drugs. No alcohol. No exceptions. No discussion. ______ _______ PRIDE IN ONE’S WORK

Pride: A sense of one’s own proper dignity or value; self-respect. Pleasure or satisfaction taken in an achievement.

______ _______ WILLING TO LEARN

Learn: To gain knowledge, comprehension or mastery of through experience or study. Will: The mental faculty by which one deliberately chooses or decides upon a course of action.

______ _______ WORKS WELL WITH CO-WORKERS

Gets along with, and respects, all other employees in a business/working environment.

______ _______ COOPERATES AS PART OF A TEAM

Cooperate: To work or act together toward a common end or purpose. Comply: To act in accordance with another’s command, request, rule or wish. Acquiesce: To consent or comply without protest.

______ _______ FLEXIBLE

Responsive to change; adaptable. ______ _______ COMPLETES TASKS ON TIME

Totally finish the task or activity in as short a period of time as possible, without sacrificing accuracy.

______ _______ ENTHUSIASM FOR WORK

Enthusiasm: Great excitement for or interest in a subject, cause, or activity.

E S ______ _______ FOLLOWS WORK RULES

Complies with all rules and policies detailed by the supervisor and/or the company employee manual.

______ _______ TREATS CUSTOMERS WELL

Understands the value of the customer: Without customers, there would be no job. Treat customers the way he/she would like to be treated. Takes a genuine interest in making certain the customer is completely satisfied.

______ _______ USES COMMON SENSE Adjective: Having or exhibiting native good judgment.

Noun: Sound judgment not based on specialized knowledge.

______ _______ SHOWS INITIATIVE

Initiative: The power or ability to begin or to follow through energetically with a plan or task; enterprise and determination.

______ _______ ACCURATE IN ONE’S WORK

Accurate: Acting or performing with care and precision; to do with care.

______ _______ WORKS WITH MINIMUM SUPERVISION

The ‘good’ employee is able to complete all tasks efficiently as well as identify other tasks, which need to be done.

______ _______ BASIC WRITING SKILLS

The ‘good’ employee is able to write legibly, displaying a command of the English language and proper grammar.

______ _______ BASIC COMPUTER SKILLS

Is able to navigate the Internet and has a working knowledge of Microsoft Word, Office and Excel. Demonstrates accurate keyboarding skills.

______ _______ PROBLEM SOLVING SKILLS

Has the ability to objectively look at a situation and work through a difficulty in a timely manner.

Name______________________

ETHICS IN THE WORKPLACE “Doing the Right Thing”

Work Based Learning Assignment #4

Work ethic is commonly understood to mean hard work. It is the discipline of giving your best effort. If a person has a good work ethic, others see them as being responsible, dependable, and trustworthy. They have achieved a level of integrity that is highly regarded in the world of work. One source (Miller & Coady) suggests that “work ethic refers to the beliefs, values, and principles that guide the way individuals interpret and act upon their job rights and responsibilities within the work context at any given time.” This assignment is about ethics. Throughout your life you will be faced with many situations, which will require you to make decisions and follow through with actions based on your sense of right and wrong. Your life experiences and personal convictions can be your guide to doing the right thing. “Work joyfully and peacefully knowing that right thoughts and right efforts inevitably bring about right results.”…James Allen This assignment is in three parts representing your past, your present, and your future. You will examine:

1. How your beliefs, values, and principles were formed and reinforced. 2. How these qualities help you behave ethically in your current workplace. 3. What you expect of yourself in your future career.

Directions: Write your name on each page of this assignment. Write the due date on your time sheet for that week to help you remember. Read and complete each of the following items. Part 1 Work Ethics and Your Past

1. Reflect on the above quote, “Work joyfully…” What message do these words communicate to you?

2. Look up each of the following words in a dictionary. Re-write the definition using

your own words.

Ethics – Integrity – Unethical –

3. From the time you were very young, your family influenced the development of your values, or what they believe is important in life. Interview an adult family member who has influenced you (parent/guardian, grandparent, aunt/uncle, or other significant adult). List 3-5 beliefs of your family that you think had a positive influence on your work ethics.

Name and relationship of person interviewed:__________________________

4. List 3-5 behaviors you learned in school that help you behave ethically on your job. (Hint: Talk with teachers and friends for their ideas before you write your list.)

Part 2 Work Ethics and Your Present

1. How do the behaviors listed in Part 1, question #4 help you behave ethically on your

current job? Give 3 examples. 2. Unethical behaviors may include, but are not limited to, the following:

Blaming others Lying

Deception Being disrespectful Quitting without notice Stealing Betraying confidentiality Excessive complaining

Taking care of personal matters on company time Improper use of employee discount Taking credit for someone else’s work Improper use of the internet a) What are 3 or more behaviors you have observed in your workplace that you would consider unethical? Explain. b) Do you think it is okay to practice unethical behaviors in the workplace because that is what others are doing? Why or why not?

3. You have asked your employer to write you a letter of recommendation to help you get your next job. What would you like your employer to say about your work ethics? Use the back of this paper for your response.

CACC Work-Based Learning

Recognition of Hazardous Occupations

Business Name ______________________________________________________________ Business Address ____________________________________________________________ Supervisor/Employer Name & Phone _____________________________________________ TO THE EMPLOYER:

The US. Department of Labor Regulations provides exemptions for youth working in a “Hazardous Occupation” and/or working on hazardous equipment. Under specific conditions 16 and 17 year old Student Learners, Trainees and/or Apprentices may be exempt if enrolled in the appropriate CTE program with written Occupational Training Agreement and Training Plan stipulating the following:

• Hazardous work is incidental to training. • Hazardous work is intermittent & under the direct supervision of a qualified person. • Safety instruction is provided to the student by the school and the employer. • There is preparation of a schedule of work processes to be performed at the worksite. • Student Learner, Trainee or Apprentice has received previous training by the school and

mastery is documented for all hazardous order job duties listed on the Occupational Training Agreement.

Attached is a copy of Michigan’s Youth Employment Standards Act. Using this document as a reference, please list or describe any “Hazardous Work” job duties the student may perform at the worksite or any “Hazardous equipment” the student may

operate at the worksite.

The employer agrees to abide by the above stipulations regarding “Hazardous Occupations” job duties and will provide the student with appropriate safety information, direction, and training for the all hazardous job duties and operation of hazardous equipment listed above. Employer Signature ___________________________________________ Date _________________ Notice of Nondiscrimination: Ingham Intermediate School District is in compliance with federal laws relating to nondiscrimination. It is the policy of Ingham Intermediate School District not to discriminate on the basis of race, color, national origin, gender/sex, age, disability, height, weight, marital status, or lack of English language speaking skills, in its programs, services or activities. The following person has been designated to handle inquiries regarding the nondiscrimination policies: Director of Human Resources, 2630 West Howell Road, Mason, MI, 48854. (517) 676-1051.

6

Getting to Know Your Work Place Work Based Learning Assignment #1

1. What is the name of your supervisor(s).

3. What are the hours your place of employment is open?

4. What hours do you normally work?

5. Where and when is the work schedule posted?

6. What is the dress code at work?

7. What day are you paid?

8. What is the attendance policy?

9. What is the policy if you are sick and you cannot go to work?

10. Do you have any concerns at this time about your job, supervisor, etc?

LOCAL SCHOOL DISTRICT FIELD AUDIT PROGRAM

P. Work-Based Education

2. Written training agreement in place

3. Pupil attendance records

4. Grade appropriate (CTE 11-12; non-CTE 9-12)

5. Certified teacher monitoring work

6. Credit toward high school diploma

7. Training takes place during scheduled class time (Gen. Intern. & CTE)

8. Documentation as of count date

9. Work time < 51% FTE

Unpaid: 10. Training not exceed 45 hours per experience

In-District: 11. CTE or Tran. Services Plan only

12. PSN included or Transition plan attached

Out of District: 13. Workers comp. and general liability insurance

14. Visitation plan

Paid: 15. Work time < district maximum

16. FTE supported by number of hours worked

17. FTE calculations verified

State-approved, Less-Than-Class-Size Programs additionally:

1. Vocationally certified instructor under jurisdiction of contractor

2. No more than 4 pupils at a time

3. Minimum of 120 or 240 hours

4. Signed and completed notification sent to OCTP Fri. after count day

Registered Apprentice additionally

1. One journeyman per apprentice

2. Apprenticeship agreement

3. Capstone requirements met

* Employer, school, and pupil's responsibilities

1. Written training plan. * Alignment with career pathway * Related course instruction * Required signatures * Performance elements/job skills used to assess pupil progress

* Required signatures * Dates of safety instruction * Workers compensation and general liability insurance * Nondiscrimination assurances * Daily hours to be worked, including beginning and ending times

eb\auditing\FA program WBL.xls\Audit program Page 1 4/2/2010

WORK BASED LEARNING

PROGRAM JOB APPLICATION Date________________

PLEASE PRINT OR TYPE Name __________________________________________________________ Last First Middle Initial Home Address____________________________________ Home Phone_________ Number Street City + ZIP Sex- M F Do you have dependable transportation to get to a worksite? ___Yes ___No Date of Birth ___/___/_____ Current Age _____ Local School ___________________ Head of Household _______________________________________ Work Phone ___________ Last Name First Relationship Other Parent/Guardian _____________________________________________ Work Phone ___________ Last Name First Relationship Local School Counselor _______________________________ Year of Graduation ___________ EMPLOYMENT DESIRED Position ________________________________________ Date You Can Start _____________ EDUCATION Name and Location of School Years Attended List classes taken

High School

College

Trade, Business Or Vocational School

List Your Activities, Hobbies and Special Interests: ___________________________________ ______________________________________________________________ ______________________________________________________________ ______________________________________________________________

2A

Are you currently employed? ___Yes ___No If so, may we inquire of your present employer? ___Yes ___No LIST BELOW ALL PRESENT AND PAST EMPLOYMENT, BEGINNING WITH YOUR MOST RECENT Month and Year

Name and Address of Company

Salary

Position

Reason for Leaving

From: To:

From: To:

From: To:

PERSONAL REFERENCES (Not former employers or relatives) Name and Occupation Address Phone Number PHYSICAL RECORD 1. Do you have impairments—physical, mental or medical—that would interfere with your ability to do the job for which you have applied? ____ Yes ____ No

If yes, explain: ___________________________________________________________________________

2. Have you ever collected compensation for an accident or injury? ____ Yes ____ No

If yes, WHEN? _______________________FROM WHOM? ________________________ WHY? __________________________________________________________________

Have you ever been convicted of a felony or misdemeanor other than a minor traffic violation? _______ If yes, give details _______________________________________________________________ In case of an emergency, please notify: Name __________________________ Relationship _________________ Phone Number ________ I HEREBY AUTHORIZE THE INVESTIGATION OF ALL STATEMENTS CONTAINED IN THIS APPLICATION. PERMISSION IS GIVEN TO CONTACT REFERENCERS AND EMPLOYERS. I UNDER-STAND THAT THIS APPLICATION WILL BECOME PART OF MY PERMANENT FILE AND THAT ANY MISREPRESENTATION, MISLEADING, OR UNTRUTHFUL STATEMENT OR OMISSION IS CAUSE FOR DISMISSAL. ___________________________ ________________________________________________ Date Signature 09/08 Ingham Intermediate School District is an Affirmative Action/Equal Opportunity District

2B

CACC WORK-BASED LEARNING PROGRAMS FORM CHECKLIST

Student Name + Local School__________________________________________ CACC Program ________________________________AM________PM________ Instructor + Coordinator/Designee______________________________________ Type of Work-Based Learning Program: PAID ______ UNPAID ______ Student has reached “concentrator” status and:

A) Has completed 50% of State required program curriculum minutes as documented in Instructor Grade Book.

B) Has mastered a minimum of 50% of program minutes, including safety and hazardous job duty instruction as documented in Instructor Grade Book.

C) Will attend a minimum of one class session per week as documented by Instructor Grade Book.

FORM TITLE CHECK/DATE

1

Form Checklist (White)

2

Program Application (Buff)

3

Medical Release (Yellow)

4

Parent/Guardian Approval & Transportation Verification (Green)

5

Safety & Risk Management (Buff)

6

Hazardous Occupations (Yellow)

7

Student Commitment (Green)

8

Training Agreement (White)

9

09/08

Training Plan (White)

CACC Work Based Learning

Medical Release Form

I (we), the parent(s)/guardian(s) of ___________________________________ (Print students name) grant permission to have the above named student transported to:

the nearest medical facility in the event of a medical emergency.

__________________ hospital in the event of a medical emergency.

Permission is granted to the medical facility to administer treatment to the above named student.

_____________________________________ ___________________ Parent/Guardian Signature Date

_________________ ______________________ ___________________ ** Emergency Telephone Numbers **

Other Student Information

Our son/daughter has had tetanus shot __________________ Date Our son/daughter is covered by our family medical insurance Insurance Company______________________ Policy/Group Number ____________________ Our son/daughter is NOT covered by any medical insurance. Our son/daughter has taken out the school health insurance policy. Notice of Nondiscrimination: Ingham Intermediate School District is in compliance with federal laws relating to nondiscrimination. It is the policy of Ingham Intermediate School District not to discriminate on the basis of race, color, national origin, gender/sex, age, disability, height, weight, marital status, or lack of English language speaking skills, in its programs, services or activities. The following person has been designated to handle inquiries regarding the nondiscrimination policies: Director of Human Resources, 2630 West Howell Road, Mason, MI, 48854. (517) 676-1051.

3

Work-Based Learning Training Agreement Non-CTE Program

District: School Year: Building:

Student/Learner Information Last Name: ___________________ First Name: _____________ Middle Initial: ___ Grade (9-12 Only): _______



School District Information

Certificated Teacher/Coordinator: ___________________________________________________________________

Telephone Number(s): ___________________________ ______________________________________________

Employer Information Name of Business: Supervisor:

Address: Phone:

City: Zip:

Worker’s Disability Carrier: Policy No.: ______________________________________________

Liability Insurance Carrier: Policy No.: ______________________________________________

Placement Information

Type of Placement (check one): Paid Unpaid [If this is an unpaid work-based learning experience, specific, unduplicated skills that the pupil will be learning need to be listed on the training plan for each 45 hours of placement.

Job Title: Date Employment Begins:

Date Employment Ends:

Safety instruction has been provided by the school or employer: ______ Date(s) of Safety Training:______________

Schedule for Site Visitation: ________________________________________________________________________

Hours to be worked: (For unpaid experience – must occur during scheduled classroom time. If not, the exception must be documented)

Mon Tue Wed Thu Fri Sat Sun

Earliest

Latest

Avg. Hrs. Per Day*: Max Hrs. Per Week**: Starting Wage (if paid):

*Cannot compute to more than ½ of the pupil’s FTE. **Work and school hours cannot exceed 48 hours per week for students under age 18

Number of credit hours to be granted: Name of Related High School Academic Course: ________________________________________________________

Training Plan IN ORDER FOR THIS TRAINING AGREEMENT TO BE VALID, A RELATED TRAINING PLAN FOR THE PUPIL BEING PLACED MUST BE ATTACHED OUTLINING THE SPECIFIC PERFORMANCE ELEMENTS/JOB SKILLS THAT THE STUDENT WILL BE LEARNING. Attached

NON-CTE WBL TRAINING AGREEMENT/Page 2 Student Responsibilities [Local district determines these responsibilities] 1. Transportation to and from the training site, for the duration of the placement, is the student’s responsibility. 2. The trainee must maintain a passing grade in the related course to pass the work experience and remain in the program. 3. Any student who will be tardy or absent from the scheduled work time must notify their employer. 4. Any student who skips school, will have the work based learning placement reviewed and may be removed from the program. 5. Should any problems arise at work or school that may affect the student’s placement, the student should notify the coordinator immediately. 6. Students are required to obtain permission from the designated certified teacher/coordinator before quitting any work-based

learning placement. 7. Students are required to complete weekly work hour reports to the coordinator. Failure to complete these required hour reports will result in the student failing the work experience. 8. Students will adhere to all safety requirements specific to this placement as identified by MI-OHSA and their supervisor. 9. Students who are absent from school are not permitted to work that day at their placement and must notify the employer. School Responsibilities [Local district determines these responsibilities] 1. The placement relates to the student’s career/education goals as outlined in their education development plan (EDP). 2. The vocationally certificated teacher/coordinator makes at least one visit, every nine weeks, to the training site. 3. Student is regularly supervised by certified staff and provided instruction in areas of skill attainment and work safety. 4. High school completion credit is granted upon successful completion of the placement. 5. Daily attendance is recorded. 6. The program must not violate the Fair Labor Standards Act and the Youth Employment Standards Act. Employer Responsibilities [Local district determine these responsibilities] 1. The employer will provide the trainee with the broadest occupational experience in keeping with the job duties listed in the training plan and provide specific instruction on the use of any equipment or materials related to job duties. Documentation of this instruction should be maintained in the trainee’s employment file. 2. The employer will ensure the student learner’s employment activity is supervised by an experienced and qualified person (work-based mentor), and will complete trainee performance evaluations and verify attendance as required. 3. A written evaluation of student performance will be completed based on the performance elements and job skills listed in the

training plan. 4. The employer will provide a training site that is free of obvious hazards that could cause potential injury or harm to the

student. The signature of the employer below certifies that the employment of the student learner will conform to all federal, state and local laws and regulations, including those that prohibit discrimination against any applicant or employee because of race, color, religion, national origin or ancestry, age, gender, height, weight, marital status or disability. Student’s Signature Date Parent’s Signature Date Vocationally Certificated Teacher/Coordinator Signature Date ___________________________________________________________________________________________________________________ Principal or Designee Signature Date Employer Printed Name and Signature Date NOTICE OF NONDISCRIMINATION: _______ District is in compliance with federal laws relating to nondiscrimination. It is the policy of the _______________________School District not to discriminate on the basis of race, color, national origin, gender, age, disability, height, weight or marital status in its programs, services or activities. The following person has been designated to handle inquiries regarding the nondiscrimination policies:

OCCUPATIONAL SKILLS Work Based Learning Assignment #5

The purpose of this assignment is for you to identify skills that you either have or plan to acquire that match potential occupations, and find ways to practice these skills at your current job. You will select five skills to work on during this trimester. Directions: You will need access to the internet in order to complete this assignment. Complete each of the following steps: 1. Locate the following web site: online.onetcenter.org

2. Select: Skills Search 3. Complete the skills search and select Go at the bottom of the screen.

4. Print the list of occupations that match your skills.

5. Choose three occupations from the list that you are interested in exploring

further. Highlight them on the paper copy.

6. Select both Summary and Details and read about each occupation.

7. Select one occupation that you are most interested in at this time.

8. Select the Skills category and review the list of skills needed for this occupation. Print this list.

9. Choose five of these skills to work on during this trimester. Highlight

them on the list.

10. For each skill, describe what you can do in your current job to become more proficient. Keep a journal documenting how you are learning and practicing each of these skills on your job. You must have two entries for each skill is the minimum requirement.

STATE BOARD OF EDUCATION

KATHLEEN N. STRAUS – PRESIDENT JOHN C. AUSTIN – VICE PRESIDENT CAROLYN L. CURTIN – SECRETARY MARIANNE YARED MCGUIRE – TREASURER

NANCY DANHOF – NASBE DELEGATE ELIZABETH W. BAUER REGINALD M. TURNER CASANDRA E. ULBRICH

608 WEST ALLEGAN STREET P.O. BOX 30008 LANSING, MICHIGAN 48909

www.michigan.gov/mde (517) 373-3324

JENNIFER M. GRANHOLM GOVERNOR

MICHAEL P. FLANAGAN SUPERINTENDENT OF PUBLIC INSTRUCTION

Work-Based Learning Program Overview and Resources Office of Career and Technical Education

Diana Bailey, Program & Placement Specialist 517-373-8904 or [email protected]

State-Approved CTE Work-Based Learning Placements (Grades 11-12)

1. Paid Work-Based Learning Experience (Capstone) State-Approved CTE Programs

The pupil must have successfully completed 50% or more of the minimum number of minutes allowed for OF a State-Approved CTE program. [This equates to 6 segments of the 12 segments required for a State-Approved CTE program.]

Vocationally certificated teachers or coordinators may use Blackboard, Moodle, or another web-managed tool for the 40-minute capstone requirement instead of the pupil returning to the related CTE program or to a “capstone class.”

2. Unpaid Work-Based Learning Experience State-Approved CTE Programs 3. In-District Unpaid Work-Based Learning Experience State-Approved CTE Programs

4. Unpaid Training State-Approved CTE Less-Than-Class-Size (LTCS) Programs

Because LTCS programs are equivalent to regular CTE programs where all 12

segments must be delivered in order to qualify, these programs must be more than one semester or trimester in length.

LTCS Programs are required to report their instructional design using the 12 segment structure on CTEIS.

In-District (In-School) Placements In-school placements are only be allowed for high school students who are either: (1) placed from a related state-approved career and technical education (CTE) program, or (2) directly related to the postsecondary career and employment goals and objectives in the pupil’s transition services plan developed for a pupil receiving special education services. If an in-district placement relates to a state-approved CTE program, the completed in-district placement agreement MUST identify the program serial number (PSN). If the PSN is not filled in, it WILL result in an FTE deduction. An in-district placement is not an experiential learning course. Non-CTE Work-Based Learning Placements (Grades 9-12)

1. Paid or Unpaid Work-Based Learning Experiences 2. Work-Based Learning Experiences for Pupils with Disabilities 3. In-District Placements for Pupils With a Transition Services Plan

STATE OF MICHIGAN DEPARTMENT OF EDUCATION

LANSING

November 2009

2

Experiential Learning Courses Experiential learning courses (non-CTE students) must receive local school board approval and must be part of the student handbook. The course must be part of the pupil’s class schedule and must earn credit toward the pupil’s high school diploma. Experiential learning courses must be taught by a certificated teacher employed by the district. The primary responsibility of the certificated teacher of the course is teaching the pupil(s) during the course time frame. That is, the teacher shall not be concurrently teaching another course. Sample Training Plan and Training Agreements (see Work-Based Learning Guide/Sections 8 & 9)

1. Training Plan 2. State-Approved CTE Training Agreement 3. Non-CTE Training Agreement 4. In-District Placement Agreement

State-Approved Career and Technical Education (CTE) Programs Your school district’s state-approved CTE programs may be obtained by contacting your regional CTE administrator OR career and technical education director. The CEPD administrator or CTE director has access to the Secondary Funding Report – Final X0107 via the CTEIS website. Pupil Accounting Manual/Section 5P www.michigan.gov/mde and type in at search: “Pupil Accounting Manual” or go to: http://www.michigan.gov/mde/0,1607,7-140-6530_6605-22360--,00.html Pupil Accounting Rules (Effective September 22, 2008) http://www.state.mi.us/orr/emi/admincode.asp?AdminCode=Single&Admin_Num=34000001&Dpt=ED&RngHigh= Pupil Auditing Manual www.michigan.gov/mde and type in at search: “Pupil Auditing Manual” or go to: http://www.michigan.gov/documents/2005_PUPILAUDITINGMANUAL10-05_143792_7.pdf Work-Based Learning Guide for Risk Management www.michigan.gov/octe and type in name at search or go to: http://www.michigan.gov/mdcd/0,1607,7-122-1680_2629_2722-17155--,00.html Sites for Sample Training Plan Skills and Related Academic Skills

o Non-CTE Work-Based Learning: http://online.onetcenter.org/ o CTE Work-Based Learning: CTE Program Standards (Performance Elements) must be

utilized to develop CTE work-based learning training programs (capstone, unpaid, in-district and less-than-class-size) that contribute to the pupil’s progress toward a career objective. The CTE standards (performance elements) can be found as follows: www.mccte-fsu.org/ -- “View Curriculum Standards”

Safety Training Sites

http://www.youthrules.dol.gov http://www.passesedge.org/main.asp

3

http://www.osha.gov/SLTC/teenworkers/teenworkers.html http://www.michigan.gov/miosha

Education Development Plans EDP Fundamentals: http://www.michigan.gov/documents/edpfund_18129_7.pdf Sites for EDPs: Career Cruising: http://www.careercruising.com/

Michigan Virtual University, MyDream Explorer/MOIS: http://www.mois.org/ National Labor Supply/Demand Information: The Georgia DOL, in cooperation with the Georgia Career Information Center at Georgia State University, was awarded a grant from DOL/ETA to work on supply/demand issues. The Occupational Supply Demand System (OSDS) is now completed. Data is organized by Units of Analysis or groups of related occupations and training programs. One way to access information that is of interest to you is by clicking on "Career Clusters". The OSDS website address is: www.occsupplydemand.org. School Records/Retention and Disposal Schedule Under “1406 Student Work Permits. Minors over the age of 14 must have a work permit prior to beginning work. Schools must approve the work permit, and new permits are required for each new job held by the teenager. These records may include the completed permit forms, job offers, approved deviations, correspondence, injury reports, workers compensation documents, work/school training agreements/contracts, etc. ACT + 7 years. ACT = until graduation.” The current School Records/Retention and Disposal Schedule may be accessed at: http://www.michigan.gov/documents/hal_mhc_rms_local_gs2_171482_7.pdf Transition Services Resource The goal of DO-IT (Disabilities, Opportunities, Internetworking, and Technology) http://www.washington.edu/doit is to increase the successful participation of individuals with disabilities in challenging academic programs and careers such as those in science, engineering, mathematics, and technology. DO-IT's website features electronic resources, publications, comprehensive training materials, videos, workshops and events (some online) on WBL as well as work preparedness. Curriculum and lesson development databases are provided as well. Professional Development/Training Opportunities Michigan Career Placement Association: www.edzone.net/mcpa/ Michigan Pupil Accounting and Attendance Association: www.mpaaa.org

Updated: July 2009

WORK-BASED EDUCATION PUPILS - PAID LEARNING EXPERIENCES

District: School Year:

Building/Program: Count: Sept. Feb.

CTE

Non-

CTE

Pupil Name (Last, First, MI) Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

Authorized Representative's Signature Title Date

(Check One)

Program

Type

Did

th

e p

up

il r

ece

ive

safe

ty

inst

ruct

ion

?

Tra

inin

g a

gre

emen

t in

pla

ce?

Tra

inin

g p

lan

in

pla

ce?

Did

th

e em

plo

yer

ver

ify

att

end

an

ce?

Is t

he

pu

pil

eli

gib

le t

o

rece

ive

HS

cre

dit

?

I certify that this is a true and accurate list of all paid work-based learning pupils enrolled in CTE/Capstone or General Education programs and

reported for FTE membership.

Do

es t

he

emp

loy

eer

ma

inta

in w

ork

ers

com

p &

gen

era

l li

ab

ilit

y i

nsu

ran

ce?

Did

th

e w

ork

ho

urs

gen

era

te <

50

% o

f th

e

pu

pil

s F

TE

?

Did

/Is

the

pu

pil

rece

ivin

g

inst

ruct

ion

in

a r

ela

ted

edu

cati

on

al

co

urs

e?

Do

es t

he

pu

pil

s p

lace

met

n

ali

gn

wit

h t

hei

r ca

reer

pa

thw

ay

?

Is t

her

e a

vis

itio

n p

lan

in

pla

ce?

Are

th

e w

ork

site

ho

urs

les

s

tha

n t

he

ma

xim

um

ho

urs

set

by

dis

tric

t?

Gra

de

(9-1

2 o

nly

)

Instructions: Complete the report below for all pupils enrolled in CTE/Capstone or General Education work-based programs.

FTE

Membership

Reported

District: School:

CTE Non- FTE FTE FTE

Pupil's Name Grade (11-12) CTE (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) Calc. Rep'd Adjust.

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

*Specifies the responsibilities of the pupil, employer, parent(s), teacher coordinator and school district, appropriate signatures, workers comp. Insurance** Details specific job tasks to be learned by the pupil at the work site. Must show how employment is related to instruction.*** Maximum number of hours to be worked is determined by the district

Program Type Appropriate

Program

Hou

rs a

t Wor

k Si

te <

Max

***

Visi

tatio

n Pl

an

- 1 p

er 9

wks

or

30

days

SE

Cur

rent

or

Prev

. Rel

ated

C

ours

e

Alig

ns w

ith

Car

eer

Path

way

ED

P

Wor

k Ti

me

< 50

% F

TE

Wor

kers

C

omp

and

Liab

ility

Ins.

PUPILS ENROLLED IN WORK-BASED EDUCATION PROGRAMS - PAID EXPERIENCE

Count Date: February 2010

Sign

ed T

rng.

A

gree

men

t on

File

?

Sign

ed T

rng.

Pl

an o

n Fi

le?

Empl

oyer

R

ecor

d of

W

ork

Hou

rs

Safe

ty

Inst

ruct

ion

Hig

h Sc

hool

C

redi

t Gra

nted

Mon

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d by

C

ertif

ied

Teac

her

\djl\c:\my documents\ Book2 Work-Based Education-Paid 4/2/2010 2:58 PM

CACC Work-Based Learning Parent/Guardian Approval

Your son/daughter has been recommended to participate in a CACC Work-based Learning Program. Please review and check the appropriate boxes and have your son/daughter return this signed form to their instructor or Career Planning and Placement Specialist.

I approve of my son/daughter participating in a paid or unpaid CACC Work-Based Learning Program.

I do not approve CACC Work-Based Learning Programs.

of my son/daughter participating in

Transportation to and from the worksite will be as follows:

My son/daughter will drive TO AND FROM THE WORKSITE ONLY, will take NO PASSENGERS

& has a current, valid, Michigan driver’s license (We require a copy of your son/daughter’s driver’s license).

Parent/Guardian will provide student’s transportation. Other transportation will be used (please specify): __________________________________________________ Parent/Guardian Signature ___________________________ Date ________ Notice of Nondiscrimination: Ingham Intermediate School District is in compliance with federal laws relating to nondiscrimination. It is the policy of Ingham Intermediate School District not to discriminate on the basis of race, color, national origin, gender/sex, age, disability, height, weight, marital status, or lack of English language speaking skills, in its programs, services or activities. The following person has been designated to handle inquiries regarding the nondiscrimination policies: Director of Human Resources, 2630 West Howell Road, Mason, MI, 48854. (517) 676-1051.

4

Work-Based Learning Paid & Unpaid Learners

2009-2010 Guidelines

WILLIAMSTON HIGH

SCHOOL

2

I am glad that you have chosen to become a WBL student! This handbook provides information and guidance to enable WBL students to have a successful experience. Please refer to this handbook when you have a question or contact Mrs. Lynch at (517) 655‐2142, ext. 7290.

The WBL experience is designed to build on skills acquired in coursework. This experience provides students with a combination of school‐based preparation and supervised work experience intended to enable students to acquire attitudes, skills, and knowledge for career and other life roles in real work settings. Goals of this experience include:

teach employability and technical skills, develop a sense of personal responsibility, explore career options, gain job/site specific skills, foster work‐oriented relationship with adults, understand the relevance of and the application to academic

learning, and provide alignment with the student’s career pathway and

educational development plan.

As businesses and industries in Michigan confront the challenges of a competitive and global economy, they have discovered that engaging youth in structured, well‐organized programs at the workplace is a strategy being used to develop a skilled workforce. Nationally, organizations were surveyed and discovered that those organizations, which participated in work‐based programs that brought youth into the workplace saw evidence of positive characteristics displayed by their workforce. The workforce was more likely to:

have more years of schooling use computers as part of their job use job rotation, benchmarking, and other total quality

Introduction

What is WBL Experience?

Why should youth engage in WBL?

3

management tools have reported an increase in the skill requirements for their

current job

WBL students earn elective credits per trimester. Grades will be determined by the following:

Timesheets Employer Evaluation Coordinator Evaluation Regular Meeting Attendance Assignments

Do

Dress appropriately. Look around; dress as your co‐workers do (or better)

Report to work on time. Behave as a professional. You’re not just a student anymore Show up for work everyday you are scheduled Be enthusiastic about all work assignments. Go above and beyond! Accept constructive criticism graciously and look at it as ways to

help you improve Offer your assistance and support to co‐workers Be an honest, trustworthy employee Communicate openly with your supervisor Listen carefully and take notes when necessary.

Don’t

Talk negatively about your co‐workers to anyone. Use offensive language. Use the phone for personal calls. Use the company computer to send emails or surf the net.

Grades and Graduation Credit

Etiquette in the Workplace

Michigan Career Pathways

4

Career Pathways are large groups of careers that share similar characteristics and whose employment requirements call for many common interests. Strengths and competencies. Career Pathways can assist students in finding their way among the thousands of different occupations available. Following a career pathway makes it easier to identify career choices. Career pathways can help develop a plan on how to prepare for a chosen career interest area. Your WBL job must coordinate with your chosen Career Pathway. Michigan’s Career Pathways:

Arts & Communication Business, Management, Marketing and Technology Engineering/Manufacturing and Industrial Technology Health Sciences Human Services Natural Resources and Agriscience

Hour and Wage Division www.michigan.gov/wagehour Occupational Safety and Health Admin. www.osha.gov Worker’s Compensation www.michigan.gov/wca Benefits to Student Clarify career goals Use state‐of‐the art techniques and equipment Develop professional relationships to broaden employment options Apply classroom theory to a realistic work setting Prepare for full‐time employment Typically earn higher wages than non WBL students Builds self‐confidence Experience success at school and work

On-Line Resources

WBL Benefits

5

Benefits to Employer Contribute to the enrichment of education Connect school‐based and work‐based training Have access to reliable, motivated, and skilled individuals Screen students for part‐time employment and possible removal from

the program. Promote communication between school and community Provide source for future workers who have learned first‐hand about

your business

Benefits to School Develop a shared relationship with the business world Make the school more relevant to the needs of the students Encourage greater community support Improve placement and employment rate of graduates Offer the student access to equipment not available at school Improve attendance Provide service to community

Students wishing to participate in the WBL Experience must abide by the following guidelines:

Juniors may only be enrolled for one hour in the WBL program and seniors may be enrolled up to a maximum of 2 hours per day.

Every student must work a minimum of 10 hours per week or 120

hours per trimester.

Students will receive 1/2 credit for each hour he/she is enrolled in the WBL program. Paid and unpaid learners will receive a letter grade on their report card.

Total number of classroom hours plus the total number of work

hours cannot exceed 48 hours per week. Abide by the rules and regulations set forth for him/her by the

employer, including any dress and grooming requirements that the employer may deem desirable.

Conform to all federal, state, and local labor laws and regulations.

Be in attendance at the monthly scheduled WBL meetings.

Remain at assigned work site during the entire trimester. Job

6

changes can only take place with the permission of the coordinator.

Begin working at his/her work site only after all items listed below have been completed and are on file with Mrs. Lynch.

o have a completed application form on file o have an Educational Development Plan (EDP) on file o have a verification form (parent, student, and employer

signatures required) on file o have a training agreement on file

Students are required to complete and submit a timesheet every week to Mrs. Lynch. See calendar for due dates.

Timesheets received after the due date will be considered late and

will result in loss of points. Students absent from work for any reason are to report that

information on his/her timesheet. Students enrolled in the program may be expected to work any

day of the week including Saturdays and/or Sundays or possibly holidays.

Students are expected to maintain acceptable grades while

participating in the program. If a student’s grades fall below a 2.0 grade point average, he/she could jeopardize his/her credit.

If a student does not attend school (example: illness), he/she is

NOT permitted to work unless permission has been granted by Mrs. Lynch.

Students may work more than his/her regularly scheduled hours

on days when school is not in session or the school is operating with an alternate school schedule (example: snow days, ½ days, MEAP testing, etc.)

Suspension from school will result in suspension from work for

the same number of consecutive days. If the student terminates his/her employment without the

knowledge and consent of Mrs. Lynch or if the student is fired with just cause by his/her employer, as determined by Mrs. Lynch, the student may fail the program.

You must have your own transportation to and from your job.

7

If you will miss work or will be late for work, it is your

responsibility to contact your employer. Students must leave school at their designated time whether they

are going to work or not.

Attend all monthly WBL meetings Meet all requirements to participate in the WBL experience Obtain approval signature from parent/guardian Attend school regularly to improve employment skills Work an average of 10 hours per week Fulfill expectations and duties assigned by the employer Display professionalism at school and work Turn in timesheets every week Notify Mrs. Lynch of any problems that may arise on the job

Attendance Attendance is an important issue during the WBL experience. Your employer is counting on you to report to work every day. You must work an average of 10 hours per week. If you must miss a day because of illness, notify your work supervisor immediately. If you miss more than two consecutive days of work, notify Mrs. Lynch as well. When you are on the job, be sure to conform to your employer’s schedule and expectations. Be sure to report to work regularly and on time. Do not ask your employer for time off because of school related activities unless it’s something important such as the homecoming dance or school function you must attend. Remember, if you are absent from school you cannot work, unless the absence is school related.

Employee (student) Responsibilities

Employer Responsibilities

8

Provide job descriptions and/or company literature, if available Interview WBL candidates and make hiring decisions Determine salary for WBL assignment Furnish supervision and guidance to WBL students Verify the number of hours the student worked each week Provide direction and feedback to students Complete evaluation forms and return to Mrs. Lynch on requested dates Discuss the evaluation with the WBL student Advise Mrs. Lynch of any problems or concerns that may arise Adhere to all Federal and State laws Provide safety training

Safety instruction shall be given by the school and correlated by the employer with on‐the‐job training. It is the student’s responsibility to follow safety procedures and standards set forth by the school and the employer.

The trainee’s job site will be visited prior to the student’s placement to determine the job’s value as a learning experience and to evaluate the working environment. Mrs. Lynch will visit the trainee’s job site at least once per marking period. She will be interested in the progress you are making to achieve your learning objectives. The visit will be discussed with you and your work supervisor.

Workplace Safety

Job Site Visitations

The Interview Process

9

Job Application Form The job application is the employer’s first impression of you! Print neatly. Fill out the application in black or blue ink. Complete all sections: Put N/A if something is not applicable to

you. Do not leave blank sections. Use your resume to help you complete the application. Be accurate! Before returning the application, check it over

carefully for any errors or omissions.

The Interview: It is the student’s responsibility to set up the interview with the employer.

Bring an up to date resume. Dress appropriately. Be well groomed for the interview Take clearly written driving directions with you. Arrive 10 minutes early. It is important that you go alone to the interview. Take a good pen, social security card, proof of age, and resume. Introduce yourself and state briefly whom you are to see. You may be asked to fill out an application form before your

interview. Greet the interviewer and address him/her by using his/her proper

name. Introduce yourself and shake hands if he/she offers to do so. Remain standing until you are invited to sit down.

Do not chew gum or smoke. Speak clearly—do not mumble Leave a final good impression. Thank the interview for their time.

If you are offered the job and you want it, accept it enthusiastically. Relax—don’t claim up!

Notify Mrs. Lynch as to the interview results If the job is offered to you, notify the employer and Mrs. Lynch of

your acceptance See Mrs. Lynch to complete all documentation. Write a Thank You letter.

After The Interview

10

Sexual harassment is a form of discrimination that is against the law. Sexual harassment is not allowed in the workplace just as it is not allowed at school. Sexual harassment may be verbal, physical or visual. The harassment may be based on sex, gender or sexual orientation. It may be one incident or a series of incidents. It is always unsolicited and unwelcome behavior, and it can take many forms, including, but not limited to:

Sexually suggestive or obscene comments or gestures “Jokes” with sexual overtones Sexists jokes that are, by their nature, clearly embarrassing or

offensive Derogatory name calling Unwelcome, offensive sexual flirtations, advances and

propositions Unwelcome comments or inquiries about a person’s sex life. Persistent and unwelcome pressure for dates Display of sexually offensive pictures or photographs Verbal threats or abuse Physical contact, such as touching, patting, pinching, or brushing

against Sexual or physical assault

What can you do? If you have concerns about sexual harassment during your WBL experience, consult Mrs. Lynch immediately. Do not remain silent thinking you will offend someone or that it will go away in time.

VERIFICATION FORM

Sexual Harassment

11

FOR

WORK-BASED LEARNING

**************************************************

We have read the Work-Based Learning Guidelines and agree to comply with the guidelines/policies.

NOTE: THIS FORM MUST BE SIGNED BY ALL PARTIES ABOVE AND SUBMITTED TO

MRS. LYNCH BEFORE YOU MAY BEGIN PARTICIPATION IN THE WORK-BASED LEARNING PROGRAM.

___________________________________ Student Name (Please Print) ___________________________________ ______________ Student Signature DATE

___________________________________ ______________ Parent Signature DATE

TRAINING SITE RISK MANAGEMENT ASSESSMENT

Training Site: __________________________________________________ Date: _____________________________ Address: _______________________________________________ Employer Contact: _________________________ To ensure the health, safety and welfare of a student learner or trainee in the workplace, please check ALL areas that will or may relate to the work environment of the student learner or trainee. AREAS OF OBSERVATION: Physical: _____ Danger Areas Marked _____ Stairs

_____ Safety Glasses _____ Climbing _____ Protective Clothing _____ Reaching and/or Lifting _____ Protective Shoes/Boots _____ Outside/Grounds Work _____ Protective Gloves _____ Other_____________________________ _____ Material Handling Devices _____________________________ _____ Moving Vehicles/Equipment Awareness: _____ Hazardous Area Signs Posted _____ Reads/Understands Instructions _____ Fire Exit Signs Posted _____ Understands Work Assignments _____ Job Orders Posted _____ Training Schedules Posted _____ Uses Time Clock _____ Other_____________________________ Social: _____ Will Train One-On-One _____ Must Use Written Correspondence _____ Will Train On a Team or with variety _____ Must Communicate with Customers of persons. _____ Must Utilize Telephone Skills _____ May Report to Several Supervisors _____ Other_____________________________ _____ Must Communicate with Colleagues _____________________________ Environmental: _____ Temperature _____ Humidity _____ Noise Levels _____ Dust and/or Air Quality _____ Exposure to Chemical Hazards _____ Odor _____ Exposure to Electrical Hazards _____ Other_____________________________ _____ Exposure to Mechanical Hazards _____________________________ Comments/Modifications/Accommodations:_____________________________________________________________ _________________________________________________________________________________________________ _________________________________________________________________________________________________ Coordinator/Designee: __________________________________________________________ Date: _______________ Employer: ____________________________________________________________________ Date: _______________

09/08 Ingham Intermediate School District is an Affirmative Action/Equal Opportunity District

5

Site Visit Log 2009‐2010

Williamston High School, Work‐Based Learning Site Visitation Log 2009‐2010

Date Student Last Name Student First Name Employer Supervisor Signature/Initials

CACC Work-Based Learning Student Commitment “I Will . . . “

While in Class: ____ 1. Use my class time to complete my related training. ____ 2. Share my experiences with my classmates and teacher. ____ 3. Turn in my Attendance & Activity Report every week

, to my instructor or coordinator.

On the Job: ____ 1. Learn my work schedule and report to work on time every scheduled day. ____ 2. Dress appropriately for the job. ____ 3. Exhibit attitudes and behaviors that represent myself and my employer in a

positive manner. ____ 4. Be friendly and courteous to everyone. ____ 5. Listen to all information and follow directions given to me by my employer or

supervisor. ____ 6. Follow all policies and rules regarding worksite safety. ____ 7. Ask questions to help me understand my job and what is expected of me. I

will also ask questions to help me work through any problems I may encounter. ____ 8. Will ask my supervisor to train me on any equipment or tools that I have not

been trained to use in class, as well as all related safety precautions. ____ 9. Will perform my work as my employer expects including use of time, quantity,

and quality. ____ 10. Communicate properly including use of good grammar; do neat and accurate

work, check my work and contribute as a responsible employee. ____ 11. I will report any concerns or issues to my Placement Coordinator to help to

resolve any problems.

IF YOU ARE ABSENT FOR ANY REASON

, YOU MUST CALL THE FOLLOWING:

____ CACC Local School Employer

517-244-1306 ____________________ ____________________ Student Signature __________________________ Coordinator Signature ________________________

7

TALLY SHEET _______ Training Agreement _______ Safety Training Plan _______ EDP _______ Verification form from Guidelines _______Time Sheet #1 _______Time Sheet #2 _______Time Sheet #3 _______Time Sheet #4 _______Time Sheet #5 _______Time Sheet #6 _______Time Sheet #7 _______Time Sheet #8 _______Time Sheet #9 _______Time Sheet #10 _______Time Sheet #11

_______Time Sheet #12 _______Time Sheet #13 _______Time Sheet #14 _______Time Sheet #15 _______Time Sheet #16 _______Time Sheet #17 _______Time Sheet #18 _______Time Sheet #19 _______Time Sheet #20 _______Time Sheet #21 _______Time Sheet #22

______Assignment #1 – Getting to know your workplace ______Assignment #2 – Youth Employment Standards Act ______Assignment #3 – Business Ethics ______Assignment #4 - Ethics in the Work Place ______Assignment #5 – Occupational Skills ______Assignment #6 – Employability Skills ______Assignment #7 – Customer Service

Work-Based Learning Weekly Time Sheet June 2007

WORK-BASED LEARNING

WEEKLY TIME SHEET #10 Directions: Complete a form for EVERY week and submit on the following Wednesday for full credit. Record dates, work times, daily hours and tasks performed or reason for absence for each day. Calculate and record total hours for the week. DO NOT LEAVE ANY BOXES BLANK.

WORK WEEK Monday ___November 30,2009______ to Sunday ___December 6, 2009________

(month, day, year) (month, day, year) Student’s Name: Student’s Grade Level/Age: Grade: Age: Employer’s Name:

DAY DATE (list month and

date)

WORK TIMES (list beginning and

ending times)

DAILY HOURS (list number of total

daily hours)

TASKS PERFORMED OR

REASON FOR ABSENCE

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

TOTAL HOURS FOR THE WEEK I certify that this record of hours worked was recorded each day by the co-op student and verified by his/her supervisor. The descriptions of tasks performed and reasons for absences are accurate.

______________________________________ ________________ Supervisor or designee Date

PRINT CLEARLY

It is the policy of Williamston Community Schools that no discriminatory practices based on gender, race, religion, color, age, national origin, disability, height, weight, marital status, sexual orientation, political affiliations and beliefs, or any other status covered by federal, state or local laws be allowed in providing instructional opportunities, programs, services,

job placement assistance, employment or in policies governing student conduct and

FILL OUT

Updated: Sept 2009



Pupil's Name Employing Company

Job Title Supervisor

INSTRUCTIONS: Record hours worked and tasks performed or reason for absence for each day.

TimeDate In Out In Out

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Title DateAuthorized Representative's Signature

I certify that this record of hours worked was recorded each day by the work-based education pupil and verified by me. The descriptions of tasks performed and reasons for absences are accurate.

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Friday

Saturday

Saturday

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WORK-BASED EDUCATION - TIME & ATTENDANCE VERIFICATION

Total Hours

Tasks Performed or Reason for Absence

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Occupational Training Agreement Work-Based Learning

In cooperation with: Dansville, East Lansing, Haslett, Holt, Leslie, Mason, Okemos, Stockbridge, Waverly, Webberville, and Williamston School Districts.

Work-Site Information q In District q Out of District

Business Name __________________________________________________ _______ Department _____________________________________

Street Address __________________________________________________________ City ___________________________________________

State ____________________ Zip Code _____________________________________ Phone ( ) __________________________________

Supervisor __________________________________ Title ________________________________________ Phone ________________________

Worker Comp. Ins. Carrier ________________________________________ Policy Number ___________________________________________

Liability Insurance Carrier _________________________________________ Policy Number ___________________________________________

CACC Information

CACC Instructor________________________________________________ Phone ( ) _________________________________________

CACC Coordinator ______________________________________________ Phone ( ) _________________________________________

Assigned Program Name ___________________________________________________ Assigned Program Number (PSN) _________________

Student Goal ___________________________________________________________________________________________________________

Student Information

Name ________________________________________________________ Home Phone ____________________________________________

Address ______________________________________________________ City _________________________________ Zip _______________

Local School __________________________________________________ Grade __________________ Date of Birth ____________________

Emergency Contact & Phone Number(s) _____________________________________________________________________________________

WBL Information

Starting Date _____________________________ Completion Date _______________________________ Rate of Pay ______________________

Work Schedule _________________________________________________________________________________________________________

q Job Shadow q Paid Work Experience q Unpaid Work Experience q Apprenticeship

• If the student is under 18 years old, combination of school and work hours must not exceed 48 hours. • Hours worked in unpaid work experience are to be during class time unless noted on a separate attachment

Ingham Intermediate School District carries liability insurance on our students for Work-Based Learning for on-site and job-site work through Insurer A: Hanover Insurance Company and Insurer B: Massachusettes Bay Insurance Company.

Job Title and Duties: _____________________________________________________________________________________________________

Equipment to be Used: ___________________________________________________________________________________________________

Safety Training: _________________________________________________________________________________________________________

See reverse side for Student, School and Employer Resposibilities.

8A RESET FORM

611 Hagadorn Rd., Mason, MI 48854

In order for this Training Agreement to be valid, a related Training Plan for the student who is working must be attached outlining the specific performance elements/job skills that the student will be learning. q Attached

Student Responsibilities* The trainee/learner must maintain a passing grade in the related course to pass the work experience & remain in the program.* A student who skips school will have the Work Based Learning experience reviewed, and could be removed from the site.* Students are required to complete weekly Attendance/Activity reports and turn them over to the Coordinator or Instructor. Failure to complete

these required reports may result in the student failing the Work Experience.* Students who are absent from school are not permitted to work that day at the work site.

School Responsibilities* The work site + job duties relate to the student’s career/educational goal as outlined in the educational development plan (EDP).* The student is regularly supervised by certified staff and provided instruction in areas of work safety and skill attainment.* High school completion credit will be granted upon successful completion of the work experience.* The student’s daily attendance is recorded.* The program must not violate the Fair Labor Standards Act and/or the Youth Employment Standards Act.

Employer Responsibilities* The employer will provide the trainee/learner with the broadest occupational experience in keeping with the job duties as listed on the Training

Plan and will provide specific instruction on the use of any equipment/materials related to the job duties. Documentation of this instruction should be maintained in the trainee/learner’s employment file.

* The employer will ensure the student trainee/learner’s employment activity is supervised by an experienced/qualified person (work based mentor), and will complete performance evaluations and verify attendance/activities as required.

* A written evaluation of student performance will be completed based on performance elements/job skills listed on the attached Training Plan. * The supervisor agrees not to terminate student program participation prior to notifying school coordinator.* Supervisor will not alter the Training Agreement or Training Plan by adding or deleting training tasks and/or equipment, machinery or tools the

student may use, without written agreement of the school coordinator.• Any driving will be incidental to the job

The signature of the employer below, certifies that the employment of the student trainee/learner will conform to all Federal, State and Local laws and regulations, including those that prohibit discrimination against any applicant or employee because of race, color, religion, national origin or ancestry, age, gender, height, weight, marital status or disability.

_______________________________________________________ _______________________________________________________Student Signature Date Vocationally Certified Instructor Signature Date

_______________________________________________________ _______________________________________________________Parent/Guardian Signature Date Coordinator/Designee Signature Date

_______________________________________________________ Employer Signature Date

Notice of Nondiscrimination: Ingham Intermediate School District is in compliance with federal laws relating to nondiscrimination. It is the policy of Ingham Interme-diate School District not to discriminate on the basis of race, color, national origin, gender/sex, age, disability, height, weight, marital status, or lack of English language speaking skills, in its programs, services or activities. The following person has been designated to handle inquiries regarding the nondiscrimination policies: Director of Human Resources, 2630 West Howell Road, Mason, MI, 48854. (517) 676-1051.

8B

CACC Work-Based Learning Program

STUDENT TRAINING PLAN: 2008-2009

Student Name ____________________________________________________ Related CACC Course ____________________________ AM _____ PM _____ Instructor/Coordinator-Designee______________________________________ Employer/Business ________________________________________________ Student Job Title __________________________________________________ Student Career Goal _______________________________________________

& Related EDP Pathway _______________________________________ Training Tasks & Job Duties: [**Designated as HAZARDOUS**]

1._________________________ 11. _________________________

2. _________________________ 12. _________________________

3. _________________________ 13. _________________________

4. _________________________ 14. _________________________

5. _________________________ 15. _________________________

6. _________________________ 16. _________________________

7. _________________________ 17. _________________________

8. _________________________ 18. _________________________

9. _________________________ 19. _________________________

10. ________________________ 20. _________________________ 09/08 Ingham Intermediate School District is an Affirmative action/Equal Opportunity District

9A

CACC Work-Based Learning Program

STUDENT TRAINING PLAN: 2008-2009

Tools, Equipment, or Machinery [**Designated as HAZARDOUS**]

1. ____________________________ 7. ____________________________

2. ____________________________ 8. ____________________________

3. ____________________________ 9. ____________________________

4. ____________________________ 10. ____________________________ 5. ____________________________ 11. ____________________________ 6. ____________________________ 12. ____________________________ CACC Safety Training completed: _____________ Instructor________________ The employer agrees to provide the student with adequate training and supervision including any additional safety training for all job tasks and duties, all tools, equipment, and machinery the student may operate while at the job site. ** Site visitation will occur every 9 (nine) weeks throughout the school year. ** ** Specific dates are included on the Student Evaluation. ** Signatures: Student Learner ________________________________ Date __________ Parent/Guardian ________________________________ Date __________ Employer _____________________________________ Date __________ Instructor ______________________________________ Date __________ Coordinator/Designee ____________________________ Date __________ 09/08 Ingham Intermediate School District is an Affirmative action/Equal Opportunity District

9B

WORK-BASED LEARNING TRAINING PLAN

Student/Learner Information (Note: This training plan MUST be attached to the student’s training agreement. When attached, no additional signatures are necessary.) District: Williamston School year: 2009-2010 Building: High School Date: 9/08/09 Student Last Name: _______________________ First Name: _________________ Middle Initial: ______ Education Development Plan, Placement and Related Academic Course Verification

1. Existence of EDP Verified and placement aligns with EDP. (check one)

Yes No

2. The above pupil’s career/education goals as outlined in their education development plan (EDP) must relate to the placement as detailed on the training agreement.

Education/Career Goal(s): ________________________________________

________________________________________

3. Related Academic Course: ___________________________________________

4. Type of Placement (check one) Non-CTE Program/Concurrent or Previously Enrolled Related High School Academic Course:

_______________________________________________________________________________ State-Approved CTE Program/ Concurrent or Previously Enrolled Related State-Approved CTE

Program: ______________________________________________________________________

5. Certification of Verification

Name of Certificated Teacher: ________________________________________*

Signature of Certificated Teacher: _____________________________________ *

*For a student in a state-approved CTE program, the above verification must be made by a vocationally-certificated teacher or coordinator.

District: School:

CTE Non- FTE FTE FTE Pupil's Name Grade (11-12) CTE (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) Calc. Rep'd Adj.

1

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9

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#

* Under age 14 limited to 1 hour/day; 5 days /week

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PUPILS ENROLLED IN UNPAID WORK-BASED EDUCATION PROGRAMSOut of District Placements

General Education Internships (GE) or Career and Technical Education (CTE)


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\djl\c:\my documents\Book3 Work Based - Unpaid out dist 4/2/2010 3:03 PM

UNPAID IN-DISTRICT PLACEMENT AGREEMENT

District: School Year: Building:

IMPORTANT: In-District (In-School) Placements MUST be directly related to one of the following (check one):

STATE-APPROVED CAREER AND TECHNICAL EDUCATION (CTE) WORK-BASED LEARNING

Program serial number (PSN) of related state-approved CTE program: _______ Name of Related State-Approved CTE Program: __________________________________

If the PSN and CTE Program Name are not filled in, this WILL result in an FTE deduction POSTSECONDARY CAREER AND EMPLOYMENT GOALS AND OBJECTIVES IN THE PUPIL’S

TRANSITION SERVICES PLAN DEVELOPED FOR A PUPIL RECEIVING SPECIAL EDUCATION SERVICES

A copy of the pupil’s transition services plan must be attached to this agreement and must directly relate to the placement. Failure to meet this criteria WILL result in a FTE deduction

Student/Learner Information Last Name: _________________ First Name: _____________ Middle Initial: ___ Grade (11-12 Only): _______



In-District Assignment Information In-District Placement/Assignment: Class Period:

Certificated Teacher/Coordinator (If Related to State-Approved CTE Program, Teacher Must Be Vocationally Certificated)

Beginning Date: Ending Date: Note: Different training experiences can occur at one location if there are multiple training plans with a whole set of separate skills (no duplication of tasks) with the training agreement that clearly defines separate training experiences every 45 hours.

Hours to be worked:

Monday Tuesday Wednesday Thursday Friday

Beginning Time

Ending Time

*Hours per week: Number of High School Credits Granted: ___________

*Cannot compute to more than ½ of the pupil’s FTE.

Placement coordinator verification that safety instruction has been provided: _________(initials)

Date of Safety Training: _________

IN-DISTRICT PLACEMENT AGREEMENT/Page 2

Training Plan IN ORDER FOR THIS AGREEMENT TO BE VALID, A RELATED TRAINING PLAN FOR THE PUPIL BEING PLACED MUST BE ATTACHED OUTLINING THE SPECIFIC PERFORMANCE ELEMENTS/ JOB SKILLS THAT THE STUDENT WILL BE LEARNING. [Because this is an unpaid work-based learning experience, specific, unduplicated skills that the pupil will be learning need to be listed on the training plan for each 45 hours of placement.] Attached Student Responsibilities [Local district determines these responsibilities]

1. Complete work assignments in a timely manner. 2. Complete activity log sheets on a regular basis. 3. Complete work hours verification on a regular basis. 4. Be in assigned location on days and times scheduled. 5. Follow school’s health and safety work rules. 6. Abide by all policies and procedures of the program, school district, and the school building. 7. Maintain good attendance in school. 8. Maintain grades in all subject areas. 9. Bring assignment/work problems to attention of the vocationally certificated teacher/coordinator.

School Responsibilities [Local district determines these responsibilities]

1. The placement relates to the student’s career/education goals as outlined in their education development plan (EDP).

2. Program operates during the school day on school premises. 3. The vocationally certificated teacher/coordinator makes at least one visit, every nine weeks, to the in-district

placement training site. 4. Student is regularly supervised by certified staff and provided instruction in areas of skill attainment and work

safety. 5. The pupil is eligible to receive credit towards a high school diploma for the work-based learning experience 6. Daily attendance is recorded. 7. The program must not violate the Fair Labor Standards Act and the Youth Employment Standards Act. 8. The program is designed primarily for the benefit of the student; assignments are progressive in nature; no

wage entitlement; students do not displace district employees. 9. Students may not assist or work for independent contractors or vendors of the school district.

Student Signature Date Parent or Legal Guardian Signature Date Certificated Teacher/Coordinator Signature (If Related to State-Approved CTE Date Program, Teacher Must Be Vocationally Certificated) Principal or Designee Signature Date

NOTICE OF NONDISCRIMINATION: It is the policy of the ______________School District not to discriminate on the basis of race, color, national origin, gender, age, disability, height, weight or marital status in its programs, services or activities. The following person has been designated to handle inquiries regarding the nondiscrimination policies:

Required Attachment: Training Plan Optional Attachment: Student Schedule

District: School:

CTE Trans.

Grade PSN Plan FTE FTE FTE Pupil's Name 11-12 (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) (Y/N) Calc. Rep'd Adjust.

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Program Type

PUPILS ENROLLED IN UNPAID WORK-BASED EDUCATION PROGRAMSIN-DISTRICT PLACEMENTS - CTE or Transition Services Only


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\djl\c:\my documents\Unpd_indist_WBL.xlsx Work Based - Unpaid In-District 4/2/2010 3:06 PM

Updated: Sept 2009

WORK-BASED EDUCATION PUPILS - UNPAID, IN-DISTRICT LEARNING EXPERIENCES



CTE

Trans

Plan

Pupil Name (Last, First, MI) Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.


Program

Type

Did

/Is

the

pu

pil

rece

ivin

g

inst

ruct

ion

in

a r

ela

ted

edu

cati

on

al

co

urs

e?

In-D

istr

ict

Pla

cem

ent

Ag

reem

ent

in p

lace

?

Tra

inin

g p

lan

in

pla

ce?

Is t

h s

tud

ent'

s a

tten

da

nce

ver

ifie

d

Is t

he

pu

pil

eli

gib

le t

o

rece

ive

HS

cre

dit

?

I certify that this is a true and accurate list of all unpaid work-based learning pupils placed in-district and reported for FTE membership.

Do

es t

he

exp

erie

nce

ta

ke

pla

ce f

or

no

mo

re t

ha

n 4

5

ho

urs

per

sp

ecif

ic s

kil

l

set?

Do

es t

he

pu

pil

s p

lace

met

n

ali

gn

wit

h t

hei

r ca

reer

pa

thw

ay

?

Did

th

e w

ork

ho

urs

gen

era

te <

51

% o

f th

e

pu

pil

s F

TE

?

If C

TE

pro

gra

m,

is t

he

stu

den

t m

on

ito

red

by

a

vo

cati

on

all

y c

ert

ifie

d

tea

cher

?

Did

th

e p

up

il r

ece

ive

safe

ty i

nst

ruct

ion

?

(Check One)Gra

de

(9-1

2 o

nly

)

Instructions: Complete the report below for all pupils enrolled in Unpaid, In-District Work Based Learning Experiences

FTE

Membership

Reported

Updated: Sept 2009

WORK-BASED EDUCATION PUPILS - UNPAID, OUT-OF-DISTRICT LEARNING EXPERIENCES



CTE

Non-

CTE

Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N Y/N* Y/N

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

* - if "No", attach documented exception


Did

th

e em

plo

yer

ver

ify

att

end

an

ce?

Is t

he

pu

pil

eli

gib

le t

o

rece

ive

HS

cre

dit

?

Are

th

e w

ork

site

ho

urs

les

s

tha

n t

he

ma

xim

um

ho

urs

set

by

dis

tric

t?

Tra

inin

g p

lan

in

pla

ce?

Did

/Is

the

pu

pil

rece

ivin

g

inst

ruct

ion

in

a r

ela

ted

edu

cati

on

al

co

urs

e?

Pupil Name (Last, First)

Did

th

e p

up

il r

ece

ive

safe

ty

inst

ruct

ion

?

(Check One)

Program

Type

Gra

de

(9-1

2 o

nly

)

I certify that this is a true and accurate list of all pupils enrolled in Out-of-District, Unpaid Work Based Learning Experiences and reported for

FTE membership.

Did

th

e w

ork

ho

urs

gen

era

te <

51

% o

f th

e

pu

pil

s F

TE

?

Do

es t

he

emp

loy

er

ma

inta

in w

ork

ers

com

p &

gen

era

l li

ab

ilit

y i

nsu

ran

ce?

Is t

her

e a

vis

itio

n p

lan

in

pla

ce?

Do

es t

he

exp

erie

nce

ta

ke

pla

ce f

or

no

mo

re t

ha

n 4

5

ho

urs

per

sp

ecif

ic s

kil

l se

t?

Do

es t

he

wo

rk e

xp

erie

nce

occ

ur

du

rin

g s

ched

ule

d

cla

ssro

om

tim

e?

Do

es t

he

pu

pil

s p

lace

met

n

ali

gn

wit

h t

hei

r ca

reer

pa

thw

ay

?

Instructions: Complete the report below for all pupils enrolled in Out-of-District, Unpaid Work Based Learning Experiences

FTE

Membership

Reported

Tra

inin

g a

gre

emen

t in

pla

ce?

VERIFICATION FORM

FOR

WORK-BASED LEARNING

**************************************************

We have read the Work-Based Learning Guidelines and agree to comply with the guidelines/policies.

NOTE: THIS FORM MUST BE SIGNED BY ALL PARTIES ABOVE AND SUBMITTED TO

MRS. LYNCH BEFORE YOU MAY BEGIN PARTICIPATION IN THE WORK-BASED LEARNING PROGRAM.

___________________________________ Student Name (Please Print) ___________________________________ ______________ Student Signature DATE

___________________________________ ______________ Parent Signature DATE

WBL MEETING 2009-2010

_________Turn in all paperwork! The auditor will come and

look through my files and if your file isn’t complete, you will not get credit for WBL!

_________ I will be using Power School and Groupwise to

communicate with you! Check your groupwise often! _________Time sheets due by Wednesday of the following week. I record the hours worked and you receive a grade for

each time sheet. Turn in time sheets even during days off and vacations!

_________Work a minimum of 10 hours per week (average). You may not work and go to school more than 48 hours per week if you’re under 18. _________If you quit or get fired, you WILL receive a “0” on your

report card and possibly be removed from the program. If you are having problems at work, please see me immediately. Don’t wait until you want to quit to come see me. My job is to be a mediator between you and your employer.

_________If you are absent from school, you MAY NOT go to

work. If you obtain 10 excused/unexcused absences from school per trimester, you may be removed from the WBL program. I do check absences frequently.

_________You must remain at your current worksite for the remainder of the school year unless we have agreed on a change.

_________If you are suspended from school, you will not receive credit for any hours you worked during your suspension.

_________You must complete all assignments on time! You will be

graded down one grade for each week they are late. The due dates are on the calendar.

_________You are expected to maintain acceptable grades in

school while participating in the WBL program. If your grades fall below a 2.0 gpa, you could be removed from the program. This program is extra-curricular, school comes first!

_________You may work more than your regularly scheduled hours when school is not in session. (Ex. Snow days, MEAP testing, vacation, etc.) Free hours during Christmas vacation. _________You do not have to be at the high school during your

designated WBL time. If you do stay at school, you need to be in the library, cafeteria or working with a teacher.

_________I deal with the paper work, but you and your employer deal with what days you work, hours, etc. Remember that I grade you like any other class.

November 30, 2009 FIRST DAY OF 2ND TRIMESTER December 9, 2009 Time Sheet #10 due December 16, 2009 Time Sheet #11 due Assignment due! December 21, 2009 BEGIN HOLIDAY BREAK January 4, 2010 BACK TO SCHOOL! January 6, 2010 Time Sheet #12 due Holiday time sheets due (if you worked over break) January 13, 2010 Time Sheet #13 due January 18, 2010 NO SCHOOL – MLK DAY

January 22, 2010 NO SCHOOL – INSERVICE DAY January 27, 2010 Time Sheet #15 due January 29, 2010 Assignment due! February 3, 2010 Time Sheet #16 due February 10, 2010 Time Sheet #17 due February 12-15, 2010 NO SCHOOL – PRESIDENT’S WEEKEND February 17, 2010 Time Sheet #18 due February 24, 2010 Time Sheet #19 due February 26, 2010 Assignment due! March 3, 2010 Time Sheet #20 due March 2,3,4, 2010 FINAL EXAMS - Full Days March 4, 2010 END OF SECOND TRIMESTER

2009-2010 Work Based Learning

2nd Trimester

Work-Based Learning Programs Overview

Revised: November 2009

1

Michigan Department of Education/Office of Career and Technical Education WORK-BASED LEARNING (WBL) OPPORTUNITIES CHART An Overview of the Major Types and Related Legal/Liability Compliance Factors

(Prepared as a working document, information in this chart is a general description only and does not carry the force of legal opinion. Applicable to Michigan only.)

Major Work-Based Learning Opportunities

A. Program Description

Factors

Student/Visitor

Volunteer

Work-Based Learning Non-CTE Programs

(Paid and Unpaid*)

Work-Based Learning State -Approved CTE

Programs

(Paid and Unpaid*)

**In-District/In-

School Placements

(Unpaid*)

Minor Employee with

Work Permit

(Not WBL)

Program Types

(Note: Local districts may call different types of work-based learning by different names. This is a local determination and an acceptable practice).

- field trip - career exploration - job shadowing - day on-the-job - work-site project

- service learning - community service - service clubs - youth groups* *some youth oriented agencies are exempt from the YESA; no work permit required

-- Paid or unpaid work-based learning experiences (these can include apprenticeships)

-- Work-Based Learning Experiences for Pupils with Disabilities

-- **In-District Placement/Transitions

-- Paid or Capstone Work-Based Learning Experience State- Approved CTE Programs (these can include apprenticeships)

-- Unpaid Work-Based Learning Experience State-Approved CTE Programs

-- **In-District Unpaid Work-Based Learning Experiences State Approved CTE Programs

-- Unpaid Training State Approved CTE Less-Than-Class-Size (LTCS) Programs

-- 1. In-District Placement/Transitions

-- 2. In-District Unpaid Work-Based Learning Experiences State Approved CTE Programs

- Part-time work - Full-time work - Summer job - Volunteer work

Key Components - school sponsored - guidelines established - no work performed

- nonprofits ONLY - can’t be required - agency has operating guidelines - work permit on file at work-site (excempt from YESA if the nonprofit is “youth-oriented”) - complies with state And federal child labor provisions

-- Students in grades 9-12 -- Training Agreement -- Training Plan listing performance elements/job skills (PE/JS) -- Refer to Pupil Accounting Manual for other requirements

-- Students in grades 11-12 -- Training Agreement -- Training Plan listing performance elements/job skills (PE/JS) -- Refer to Pupil Accounting Manual for other requirements

In-District Agreement Training Plan/PE – JS 1, Placement must relate to student transition plan (copy of plan required) 2. Placement be for a student from a state-approved CTE program (PSN number required)

- work permit on file at work-site before working

- work permit issued by schools - complies with child labor provisions

Work-Based Learning Programs/Overview


2


B. Legal and

Compliance Factors

Student/Visitor

Volunteer

Work-Based

Learning Non-CTE Programs

Work-Based

Learning State -Approved CTE

Programs

*In-District/In-

School Placements

Minor Employee with

Work Permit

(Not WBL)

Documentation

- parent permission - roles/responsibilities detailed appropriate to site - activities detailed - work-site monitored by school - safety orientation

- program guidelines - roles/responsibilities detailed appropriate to site - activities detailed - safety orientation

- work-site visited prior and during - student monitored at work by appropriately certfiied teacher employed by school - work-site mentor assigned to student - student progress is assessed in skill attainment, work ethics, and attendance - training agreement and training plan (must be filed at work-site prior to placement) - safety instruction is documented

- work-site visited prior and during - student monitored at work by vocationally certified teacher employed by school - work-site mentor assigned to student - student progress is assessed in skill attainment, work ethics, and attendance - training agreement and training plan (must be filed at work-site prior to placement) - safety instruction is documented

- work-site visited prior and during - student monitored at work byappropriately certified teacher employed by school - work-site mentor assigned to student - student progress is assessed in skill attainment, work ethics, and attendance - training agreement and training plan (must be filed at work-site prior to placement) - safety instruction is documented

- original work permit on file at work-site: CA-6 for youth 14 and 15 years old CA-7 for youth 16 and 17 years old - copy of work permit on file at school - other appropriate documentation on file for minors working under exemptions

Injury to Participant

- parent health insurance may apply (medical only) - district may provide or make available short-term student accident insurance (medical only) - work-site general liability insurance should apply

sponsoring organization's workers' compensation coverage and/or general liability policy should apply

- responsibility of the individual, parent and school (Usually the party responsible for the direct supervision and receiving the benefit) - work-site general liability insurance may apply - work-site workers' compensation coverage if student is determined to be "working"

work-site workers' compensation coverage



Injury to Others Resulting From Participant's Role

- work-site general liability insurance - district general liability insurance may apply





work-site general liability insurance



3

B. Legal and

Compliance Factors

Cont.

Student/Visitor

Volunteer

Work-Based


Work-Based


Programs

*In-District/In-

School Placements

Minor Employee with

Work Permit

(Not WBL)

Hours Worked

N/A, participant not working

- restricted by state child labor provisions

- restricted by both state and federal child labor provisions - districts should have local policy mirroring state standards concerning hrs for 16 & 17 year olds

- restricted by federal child labor provisions, - districts should have local policy mirroring state standards concerning hrs for 16 & 17 year olds

- restricted by federal child labor provisions, - districts should have local policy mirroring state standards concerning hrs for 16 & 17 year olds

restricted by state and federal child labor provisions, exemptions for 16 & 17 year olds

Hazardous Occupations

N/A, no employee status, school operating policies should conform with acceptable practices

yes, school or agency operating guidelines must conform with state and federal child labor provisions

Not allowed

Certain exemptions can be applied if granted but only in limited areas - 16 & 17 year olds

Not allowed

Not allowed

Occupational Safety or Health Hazard

yes, must comply with all MIOSHA regulations and standards






Safety Training

yes, essential, both prior and during





yes, essential; employer's responsibility

Applicability of Unemployment Insurance

N/A, no employee status



time during training agreement is exempt

time during training agreement is exempt

paid by employer

Applicability of Workers' Comp. and General Liability Insurance

N/A, participants not working

coverage needed; liability under Act determined on a case-by-case basis

Employer coverage required.

Employer coverage required.

Covered by school

coverage needed; typically extended by employer

Pupil Accounting (State Aid Membership)

experience must be documented if considered part of the instructional program

experience must be documented if considered part of the instructional program

-can be released no more than l/2 of students’ FTE



part-time employment hours cannot count toward membership



4

C. Age Factors

Student/Visitor

Volunteer

Work-Based


Work-Based


Programs

*In-District/In-

School Placements

Minor Employee with

Work Permit

(Not WBL)

Under 14

yes

yes; restricted to district and agency guidelines with child labor law provisions

no

no

no

Some exemptions under the Youth Employment Standards Act (YESA)

14 and 15

yes

yes

yes

No

1) yes 2) no

yes, limited hours and work

16 and 17

yes

yes

yes

yes, limited hours and work, some flexibility under certain conditions

yes, limited hours and work, some flexibility under certain conditions

yes, limited hours and work, some exemptions allowed

18 and Over; Still in High School

yes

yes

yes, limited by local program policies



no

**For unpaid work-based learning experience, specific, unduplicated skills that the pupil will be learning need to be listed for each 45 hours of placement **Unpaid Trainees must meet the 6 federal criteria for trainee as listed below:

1- progressive training 2- benefit of trainee 3- no displacement 4- no direct benefits to employer 5- no job entitlement 6- no wage entitlement


WBL Safety Training Plan 2009-2010

Completed by Employer & Student Read, Sign & Date—Return to Mrs. Lynch

WORK BASED LEARNING SAFETY TRAINING PLAN

Student Name____ _______________________________________________________ Employer Name__________________________________________________________ Supervisor_______________________________________________________________ Administrator of Safety Training_____________________________________________ Date of Safety Training_____________________________________________________ Specific Items Covered During Safety Training (Items should include, but are not limited to: building evacuation plan, first-aid procedures, power outage procedures, specific items to work environment). ________________________________ ____________________________________ ________________________________ ____________________________________ ________________________________ ____________________________________ ________________________________ ____________________________________ ______________________________________________ ______________________ Student Signature Date ______________________________________________ ______________________ Supervisor Signature Date ______________________________________________ ______________________ WBL Coordinator Date

Debbie Lynch, WBL Coordinator Williamston High School 3939 Vanneter Road Williamston, MI 48895 517.655.2142, ext. 7290 FAX 517.655.7501

Page 1 of 2

WORK-BASED LEARNING TRAINING PLAN

Student/Learner Information (Note: This training plan MUST be attached to the student’s training agreement. When attached, no additional signatures are necessary.) District: School year: Building: Date: Student Last Name: _______________________ First Name: _________________ Middle Initial: ______ Education Development Plan, Placement and Related Academic Course Verification

1. Existence of EDP Verified and placement aligns with EDP. (check one)

Yes No

2. The above pupil’s career/education goals as outlined in their education development plan (EDP) must relate to the placement as detailed on the training agreement.

Education/Career Goal(s): ________________________________________

________________________________________

3. Related Academic Course: ___________________________________________

4. Type of Placement (check one) Non-CTE Program/Concurrent or Previously Enrolled Related High School Academic Course:

_______________________________________________________________________________ State-Approved CTE Program/ Concurrent or Previously Enrolled Related State-Approved CTE

Program: ______________________________________________________________________

5. Certification of Verification

Name of Certificated Teacher: ________________________________________*

Signature of Certificated Teacher: _____________________________________ *

*For a student in a state-approved CTE program, the above verification must be made by a vocationally-certificated teacher or coordinator.

Page 2 of 2

Performance Elements (Specific Job Skills To Be Learned)

Note: For state-approved career and technical education programs, the training plan must be developed from the related OCTP performance elements as posted on the attached link: http://www.michigan.gov/mdcd/0,1607,7-122-1680_2629_2733-145785--,00.html

If this is an unpaid work-based learning experience, specific, unduplicated skills that the pupil will be

learning need to be listed for each 45 hours of placement. Following are the performance elements/job skills that contribute to the pupil’s progress toward a career objective (attach additional pages as necessary). These performance elements/job skills will be used to assess/evaluate the pupil’s progress.

Student: _____________________________ Local School: ________________________

CACC Program: ___________________________________ AM: ______ PM: ______ FAX to: 676-3602 Attention: ________________________________

Date Day Hours Activities

Sunday

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Hourly Wage

$ Total Hours

Absence Code: NS (Not Scheduled/School Vacation); EX (Excused/Advance Notice); NE (Absent/No Advance Notice); TA (Tardy/Left Early); SD (Snow Day) ______________________________ ______________________________ ___________ Student Signature Employer Signature Date cc: Attendance/Coordinator/Instructor

Work Based Learning Attendance & Activity Report

Employer Comments: __________________________________________________________________________ __________________________________________________________________________

Youth Employment Standards Act Work Based Learning Assignment #2

Directions: Use the Internet to access the Michigan government website (www.michigan.gov/bwuc). Then search for the Youth Employment Standards Act and/or information on minor employment. Find the answers to the following questions; record them here, including the URL/site address where you found the information. Find a table that compares Michigan and Federal youth employment standards. Note that whichever set of rules in stricter is the set of rules that applies. This means that if Michigan’s laws are tougher than the federal standards, Michigan law applies, and vice versa.

1. How many hours per week can 14 & 15 year olds work during the school year?

2. How many hours per week (combined work and school) can 16 & 17 year olds work?

3. When must the employer provide a rest period? And how long should it be?

4. Who must supervise minor employees (those under age 18)?

Now search again, for “Work Permits” and answer the following: 5. What is a work permit? Did you have to get one? Why or why not?

You may need to do a separate search for “Training Agreement.” Find the information you need and answer the following: 6. What is a training agreement? Do you have one? Now search again, for “Youth Employment Required Posters”. 7. What posters must be posted in businesses that employ youth people? List all.

Work Based Learning - EdZonempaaa/Conference/S10/S3B_WrkBased_Presentati… · Work-Based Learning Count Day Time Sheet (Fall) June 2009 WORK-BASED LEARNING COUNT DAY TIME SHEET Wednesday,

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