SCWK 440

SCWK 202

Agency-Student Contract

AGENCY-STUDENT CONTRACT

Date ________________________

Name _________________________________

Telephone ___________________ Email _______________________

Address _______________________________

_____________________________________

Classification _______________________________

Agency _______________________________

Telephone ___________________

Address ________________________________________________________

Agency Supervisor ______________________________

Date begin __________________ Date end ____________________

Days expected to be in Agency ____________________________

Hours expected to work _________________________________

Attach:

1. A typed, detailed description of the structure and functions of the agency in which you have contracted to do your volunteer work. Describe the population served by the agency and your specific responsibilities.

2. The learning objectives (what you expect to learn by the end of the semester) agreed upon by student and agency supervisor. These learning objectives will reflect the objectives of the course, be obtainable and feasible within the time frame of the semester and stated in behavioral terms that can be measured at the end of the semester. For each learning objective, state how you expect to meet each objective.

THE COMPLETED CONTRACT IS TO BE GIVEN TO THE COURSE INSTRUCTOR FOR APPROVAL WITHIN THE FIRST TWO WEEKS OF THE COURSE.

______________________________________ _______________________

Student Date

______________________________________ _______________________

Course Instructor Date

______________________________________ _______________________

Agency Supervisor Date