REQUIRED FORMS CHART
Agreements are provided for each type of Community Based Learning Experience.
Select and complete the correct agreement and forms.
STUDENTS & PARENTS
509J STAFF OR VOLUNTEER (business owner, supervisor)
COMMUNITY PLACEMENT
REQUIRED FORMS & AGREEMENTS
REQUIRED FORMS
ADDITIONAL FORMS
CAREER SHADOW
· Career Shadow Experience Instructions
· Parent/Guardian Responsibility Agreement, Authorization Form
· Career Shadow Planning Guide
· Student Responsibility Agreement
· Career Shadow Sample Questions
· Career Shadow Reflection Sheet
· Career Shadow Evaluation of Student
· Sample Thank You Letter
· Volunteer Application and/or copy of current Certificate of Insurance
· Information for Local Businesses
If Business or Volunteer is concerned about their liability, they can complete the following forms:
· Criminal History Verification Form
· Volunteer Application
· Risk Management Assessment
SERVICE-LEARNING
(When a 509J Staff Member is NOT Present at the Volunteer Site)
· Student Pre-Project Worksheet
· Confidentiality Agreement
· Community Based Learning Parent/Guardian Authorization
· Vehicle Transportation Permission Form
· Vehicle Transportation Permission Form (Writable version)
· Post-Project Student Report: Service Learning
· Community Based Learning Experience Student Reflection
· Student Service Hours Log
· Student Services Record
· Any forms or training required by the Community volunteer or organization
· Criminal History Verification
· Post-Project Teacher Report: Service Learning
· Reporting Log for Workers’ Compensation Coverage
· Teacher Pre-Project Work Sheet (optional)
· Permission for Use of Private Vehicle
· Permission for Use of Private Vehicle (Writable version)
INTERNSHIPS
(Non-Paid)
· Internship Experience Course Requirements
· Internship Portfolio Assignment
· High School Internship Learning Contract
· Resume Assignment On-line Directions
· Cover Letter Worksheet
· Exploring an Occupation on the Career Information System
· Sexual Harassment Report
· Sexual Harassment Flyer
· Internship Experience: Evaluation Form
· Sample thank You Letter
· Permission for Use of Private Vehicle Form. (REQUIRED ONLY IF VOLUNTEER/STAFF WILL BE TRANSPORTING STUDENTS.)
· Internship Experience Evaluation Form
STRUCTURED WORK EXPERIENCE
(Paid)
· SWE Course Requirements
· SWE Portfolio Assignment
· SWE Learning Plan
· Resume Assignment On-Line Directions
· Related Reading Report
· SWE Self-Assessment
· SWE Evaluation Form
· Structured Work Experience Evaluation Form
Use these forms if 509J is assisting in the job placement:
· Permission for Use of Private Vehicle form. (REQUIRED ONLY IF VOLUNTEER/STAFF WILL BE TRANSPORTING STUDENTS)
· Copy of current Certificate of Insurance
FIELD TRIPS
Community Based Learning Experience Field Trips
· Field Trip Parent Permission Form
· Follow field trip requirement as outlined in Board policy.
· Follow Board policies for transporting students.
· Teacher request form: Choose regular field trip request form or extended field trip request form depending on length of the trip