Work-Based Learning Sample Forms

The forms listed below are sample forms that may be used in whole, or in part by schools as they implement work-based learning programs at the secondary level. NYSED strongly suggests that all forms be reviewed and approved by local district administrators and legal counsel before they are put into use in your district.

• Sample Student MOA
• Sample NYS Appearance Enhancement
• Sample MOA Extended Classroom
• Sample Student Agreement
• Sample Student Training Plan Template
• Sample Student Training Plan Narrative
• Sample Emergency Medical Treatment Authorization

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