Académique Documents
Professionnel Documents
Culture Documents
Spring
Semester
2015
As the undersigned, I agree to follow all policies and rules which apply to me at the site of my practicum
experience, bowing to my profile/guides judgement. Particularly, if a schedule has been set, I am
responsible for being present, on time, properly equipped and ready to begin observation, and if
applicable, participation. Should I miss scheduled practicum times, I am responsible for accepting
responsibility for my actions, including any sanctions deemed necessary by the practicum guide.
Absence should be cleared with the experience guide prior to occurring, if possible, as expected of
anyone functioning in a professional setting.
This confidentiality and policy statement is required for initiating the practicum; therefore, this
form must be signed by all those indicated below and returned for safekeeping in the course
records. A copy must be made available and provided for each party upon request. The practicum
cannot officially begin until this requirement has been met.
I, as student, agree to what is stated above and willingly sign this contract.
Signature:
Printed Name:
Date:
I, as Profile Subject (individual or site manager), agree to what is stated above and willing sign this
contract as monitor.
Signature:
Printed Name:
Date:
I, as course instructor, agree to what is stated above and willingly sign this contract as broker.
Signature:
Printed Name:
Date: