Merced County Regional Occupational Program by L2w96Gt


									                                           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. #
                                                                                                                                                                                      Class Code
                      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

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