Merced County Regional Occupational Program
Merced County Office of Education Co-op Comm. Classroom
632 West 13th Street $ Merced, CA 95340
(209) 381-6607 Student I.D. #
Community Classroom Permit/Training Plan
Last Name: First Name: Grade:_______ High School:_____________________
Address: City: Zip: Telephone: Birthdate:
R.O.P. Class Title: Counselor: ___________________ S.S.#:
Name of Site: Phone: Site No.:
Site Address: Site Supervisor: Contact Person:
Site Entry Date: Instructor: Phone:
Community Classroom Certification: This selection to be completed if the site is a community classroom site.
I understand that this student is placed in my business as an extension of his/her R.O.P. training. This Training Plan outlines the tasks the student
is to accomplish at my training site.
Signature of Community Classroom Contact: Date:
Student's Career Objectives:
DOT Classification Number: __________________________________________ DOT Job Title:
S = School TS = Training Station Est. Hrs. = Estimated hours needed to complete training
S TS Areas of Experience and Training Est. hrs. Comments
The Merced County R.O.P. program does not discriminate on the basis of race, color, national origin, sex or handicap in its educational programs and activities.
Equal Employment Opportunity
White: ROP Central Office Green: Employer Canary: Career Tech Pink: Student/Parent Goldenrod: Instructor Disk: 2 Filename: ROP13 REV.7/02