Work Based Learning Coordinator

Karen Noye  

John Jay High School • Roy C Ketcham High School•Orchard View High Schol

845-298-5100 x31077

Worked-Based Learning  

Student Agreement and Responsibilities

1. An on the job mentor will be identified and assigned to the student for the duration of the  experience.  

2. This program will comply with all Federal and State Labor Department, New York State Workers  Compensation regulations and New York State Education Department laws and regulations.  

3. The student must abide by all regulations set forth by the participating business. Failure to do so  

can cause immediate removal from the site or participating business. Special attention is called to  the employer’s regulations concerning safety, dress, conduct and attendance.  

4. The student is representing Wappingers School District in the business community, therefore he  or she is required to behave appropriately according to the expectations of the business.  

5. The student is expected to attend the worksite as per schedule. The student will give as much  advanced notice as possible if he or she is unable to report for work or will be tardy. The student  must inform the attendance office or classroom teacher of all unexpected absences from school  during his or her work-based learning experience.  

6. The student will complete all forms relative to placement and transportation prior to starting the  WBL experience. If driving a photocopy of the student’s driver’s license must be provided.  

7. The student must keep a Daily Journal, found in your Google Classroom.  

8. The student will be evaluated during the program and must maintain satisfactory standards of  performance to continue in the WBL experience.  

9. The student will not change or terminate the Work-Based Learning experience without first  consulting the WBL coordinator and mentor/ employer.  

I, the undersigned, understand and accept all of the aforementioned conditions related to my  participation in the work based learning program:  

Student name: _______________________________________  

_____________________________________________________ ___________________
Student Signature                                                         Date

_____________________________________________________ ___________________

Parent/ Guardian Signature                                                 Date

_____________________________________________________ ___________________

Work-Based Learning Coordinator Signature                                 Date

The mission of the Wappingers Central School District is to empower all of our students with the competencies and confidence to challenge themselves, to pursue their passions, and  to realize their potential while growing as responsible members of their community.