9.2: Learning Contract and Educational Plan

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HUMS 215 Learning Contract and Educational Plan

Student Name _______________________________ HACC ID __________________________________

Student Phone Number _________________________ Student Major _____________________________

Semester __________ _ Year ______________________________

County Agency is Located _________________________________________________

Agency Name __________________________________________________________

Address _________________________________________________________________________________

Phone _________________________________________________________________________________

Director ________________________________________________________________________________

Supervisor of Student ____________________________________________________________________

Supervisor’s Degree _____________________ _____ Discipline (ex. Social Work) ______________________

Supervisor’s Phone: __________________________ Email: _______________________________________

Phone number of work site: _______________________________________________________

Hours of work: (Schedule Plus Total Hours per Week) ______________________________________

Student Responsibilities

Perform tasks outlined by the Fieldwork Supervisor as guided by the Educational Plan.
Regularly attend the organization during the hours arranged for the fieldwork.
Keep track of hours completed.
Practice confidentiality and all other relevant ethical considerations.
Be prompt and active in attendance at agency conferences and supervisory sessions.
Learn how to effectively utilize supervision including accepting feedback .
Attend weekly seminars held on campus and complete all assignments.
Evaluate the Practicum placement experience using the Student Evaluation Form.
Evaluate the Human Services Program at HACC.
Comply with the Human Services Code of Ethics and the Essential Qualifications.

Fieldwork Supervisor Responsibilities

Orient the student to the purpose of the agency and its role in the Human Service Delivery system.
Define the student's role in the Agency.
Orient the student to the specific tasks the student will perform.
Oversee and implement the student's Learning Contract and Educational Plan.
Hold regular weekly supervisory meetings with the student.
Contact the Practicum Instructor at the College if there are problems in the student's job performance
or adjustment.
Help the student integrate the field work experience with classroom work.
Recommend additional reading to enlarge the student’s understanding of the Human Service field
or the client population being served.
Evaluate the student's performance in the fieldwork placement.
Evaluate the Human Services Program at HACC.

Practicum Instructor Responsibilities

Coordinate the Learning Contract and Educational Plan with student and Field Work Agency
Supervisor.
Contact the student's agency supervisor at the beginning of the semester to plan the details of the
student's field experience in accordance with agency needs and learning objectives for the course.
Plan and conduct weekly seminars on campus to involve all students in field placements.
Meet with student and/or agency supervisor individually as needed for any problems regarding
the student's adjustment or any concerns about the practicum experience.
Negotiate problems arising out of student placement.
Meet with agency supervisor and student on site for at least one time during the semester.
Determine the semester grade for each student based on the field work Agency Supervisor's
evaluation, the student's performance in the seminar, and written assignments.

*A student may be terminated in a field placement during the semester by request of the agency, the College or the student after consultation together.

Educational Plan

The Learning activities on this Educational Plan are to be completed and agreed upon by both the student and the Field Work Site Supervisor. Learning Activities need to be specific, measurable, attainable, realistic, and time-limited (SMART). Learning activities will need to be completed by the end of the practicum.

Learning Objective 1.

Learning Activities

Learning Objective 2.

Learning Activities

Learning Objective 3.

Learning Activities

Learning Contract Parties:

Student: ________ Date
Signature

Agency Supervisor: _________ Date
Signature