GENERAL HOUSEKEEPING: FORMS
Course
Practicum in
LPSCS
Rationale
The students must complete and sign all of the necessary forms to complete
this course.
Unit 0
General
Housekeeping
Objectives
The students will be able to:
1. Demonstrate characteristics necessary to be a successful student in
the LPSCS program by obtaining all signatures necessary on required
forms
2. Identify the critical rules of program operation
3. Explain the procedures for reporting an absence from school/work
4. Learn the policies and procedures of the LPSCS program
5. Obtain the necessary signatures on required forms
Essential
Question
What are the
policies,
procedures, and
paperwork that
need to be
followed and
completed to
succeed in this
course?
TEKS
§130.301(c)
(1)(A)
Prior Student
Learning
None
Estimated Time
3 hours
Engage
Use the following questions for a class discussion:
 Why are rules necessary?
 Why is daily attendance important?
Explain that it is an honor to be accepted into this program and that all
students must maintain high expectations to remain in the class. Use the
Discussion Rubric for assessment.
Key Points
I. Forms in the Students’ Packets
A. Training Plan Form
1. Used by the teacher to complete a student’s training plan
2. Can also be used by the teacher when visiting training stations, if
kept in a Visitation binder
B. Student Responsibilities
1. Very important form
2. Rules of the program should be strictly adhered to in order to avoid
problems.
3. Key rule: if a student is absent from school, that student is not to
report to work.
4. Key rule: a student may not quit a job without the teacher’s
permission, or is in jeopardy of failing the class for the grading
period.
5. Key rule: theft is not condoned. Immediate removal from the
program.
C. Syllabus
1. Details what the students will learn
2. Grading policy
D. Classroom Rules
1. A must for every teacher
2. Personalize to your methods
E. Unemployed Student Policy
F. Dependability Grade
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G. Summary Verification Signatures Form
1. Ensures the parent received all the paperwork
H. Wage and Hour Report
1. This is an auditable document and all students must keep an
accurate record of the hours worked. Keep these in the permanent
record files
Activities
Guided Practice – Customize each form to your program. Go over each form
individually and thoroughly. It is extremely important that all students
understand what is required of them in order to be in the program. Set a
deadline (usually the end of the first week of school) for all forms to be
returned with signatures. Keep in mind that during the first few days of
classes, students will leave or enter your program. You will need to keep up
with all of the paperwork and will need to see that the new students receive
all of the documents. (Note: You may want to give an incentive for returning
paperwork ahead of time (usually a small treat works well). As an extra
incentive, you may want to give a daily grade for all paperwork that is
returned by the deadline.) Use the Individual Work Rubric for assessment.
Mobile Me Activity – Have the students create a mobile about themselves
and share it with the class. (Note: Assign this on the first or second day of
class (due by the end of the first week).) Use the Mobile Me Handout to
explain the activity and the Individual Work Rubric and the Presentation
Rubric for assessment. (Note: make a mobile to present as an example to
the class. Hang all of the mobiles in the classroom for the first few weeks of
school.)
Assessments
Discussion Rubric
Individual Work Rubric
Presentation Rubric
Materials
General Housekeeping computer-based presentation
Computer with projector
Copies of all forms
 LPSCS Practicum Syllabus
 Student Responsibilities in Cooperative Training Program
 Classroom Rules
 Dependability Grade
 Policies Governing Unemployed Students
 Summary Signature Verification Form
 Wage and Hour Report
Coat hanger
String, ribbon, or yarn
A one-hole punch
Magazines
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Students personal pictures
Scissors
Glue
Computers with presentation-based software (optional)
Accommodations for Learning Differences
For reinforcement, review the following with the students:
 Why is it important to follow all rules of the program?
 Why do students have to secure permission before they quit their job?
 What happens to a student who is fired from his/her job?
 What is the policy on theft?
Use the Discussion Rubric for assessment.
For enrichment, the students will use audio/visual or computer-based
presentation software to create a professional and creative collage
introducing themselves to the class. Use the Individual Work Rubric and the
Presentation Rubric for assessment.
State Education Standards
Texas Essential Knowledge and Skills for Career and Technical Education
§130.301. Practicum in Law, Public Safety, Corrections, and Security (Two
to Three Credits).
(1)
The student demonstrates professional standards as required
by business and industry. The student is expected to:
(A)
adhere to policies and procedures;
Career and College Readiness Standards
English/Language Arts Standards
III. Speaking
B. Develop effective speaking styles for both group and one-on-one
situations.
1. Participate actively and effectively in one-on-one oral
communication situations.
2. Participate actively and effectively in group discussions.
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MOBILE ME HANDOUT
OBJECTIVE: The student will introduce his or herself to the class by creating a mobile that reflects
the individual’s interests and personality.
MATERIALS NEEDED:
Coat hanger
String, ribbon, or yarn
A one-hole punch
Pictures of you, your family, etc.
Pictures and words cut out from magazines
DIRECTIONS:
Make a mobile that depicts who you are and be prepared to share it with the class. You must include
a minimum of three pictures of yourself (or family) and at least six of the following items:
Achievements
Car you drive
Pets
Sports
Favorite nursery rhyme
Pet peeve
Favorite food
Favorite color
Favorite music
Quotation
The last book you read
Etc. (Your Choice)
Have fun with this project! We will hang them in the classroom after everyone presents his or her
mobile to the class.
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LPSCS PRACTICUM SYLLABUS
Welcome to the dynamic world of LPSCS! You have been selected from many applicants to
experience a fun and rewarding year. It is my intent for you to learn a great deal about the world of
work as you learn about yourself.
This course consists of the following topics:
 (INSERT YOUR COURSE OUTLINE HERE)
As you can see, we will cover a lot of ground this year. Please take this suggestion seriously: READ
THE TEXTBOOK! There will be a lot of information given and discussed in class that is not in the
text; however, you are still accountable for reading assigned chapters. Students entered in (INSERT
YOUR PROGRAM HERE) competition are more successful due to reading the material in the text.
GRADING:
Your grade will consist of the following: weekly work reports; dependability
grades (see
Dependability sheet); individual and group assignments; daily
work; tests; and your employer
evaluation.
YOUTH ORGANIZATION: (INSERT YOUR PROGRAM HERE)
All co-op students are expected to join (INSERT YOUR YOUTH ORGANIZATION HERE) and
to participate in competitive events. Dues are $______ for the school year.
_____________________________
___________________________
Parent’s Signature
Student’s Signature
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STUDENT RESPONSIBILITIES IN COOPERATIVE TRAINING PROGRAM
Type Your School District Name Here
Career and Technical Education Department
In order to establish and maintain a responsible, high quality type of Cooperative Training
Program for (insert name of school or school district), it is essential that the student, the parents,
the training sponsor, the coordinator, and school administrators agree to these basic principles:
1.
It is the responsibility of the coordinator to provide appropriate interview opportunities for
student job placement. The coordinator must grant final approval of all job placements.
2.
It is the responsibility of the student to remain at the same training station throughout the
training period. A change may be made only when approved by the coordinator.
3.
A student will be removed from the Cooperative Training Program and lose state credits for
any of the following reasons:
a.
If the student is dismissed from the training station and the coordinator determines that
the dismissal was for sufficient reasons. Example: theft or un-ethical conduct.
b.
The second time a student has been fired and/or quits without the permission of the
coordinator, he/she is released from the program without credit.
c.
If a student’s attendance drops below 90%, the student may be removed from the
Cooperative Education Program. Removal from the class would result in loss of credit
for the term.
4.
The student is under school supervision at school, and during the work schedule at the training
station. School credit is given for four hours spent on the job, as well as in the classroom. The
student must work a minimum of 15 hours a week, 10 of which must be Monday through
Friday.
5.
If the student is to be absent from school on any particular day for any reason, the student is
required to notify the teacher-coordinator no later than 12:00 (noon) on the day of the absence.
He/she may not report to the training station without having first received permission from the
coordinator. Failure to observe this rule will result in unexcused absences in all classes
missed.
6.
A student who is fired or quits a job shall receive a nine weeks grade no higher than 60 for the
grading period during which he/she was fired. The student is expected to find his/her own
employment within five days. Grades will be reduced from the sixth day forward.
7.
Students enrolled in Cooperative Education are expected to belong to the youth organization,
as activities are related.
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It is with the above understanding that we enter into this agreement to provide the best training for the
individual student.
_________________________________
STUDENT
______________________________
PARENT OR GUARDIAN
_________________________________
COORDINATOR
______________________________
PRINCIPAL
*** If you wish to communicate via e-mail, please list your address:
_________________________________________________________________
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CLASSROOM RULES
1. You must be in class on time; failure to do so may result in an after class detention on the day you
are late! Class is from INSERT TIME
2. Bring your materials to class and be ready to work on assignments. ALWAYS BRING YOUR
TEXTBOOK.
3. Sleeping is NOT allowed in class. We will cut your work hours if you are too tired.
4. No work from other classes is to be done in our class. You are earning credit for this course, so
you must devote your attention to our subject material.
5. Do not comb hair, put on makeup, paint fingernails, etc. You don’t have to impress us—we like
you as you are.
6. Treat all guest speakers with respect. Treat all substitutes as respectfully as you treat me.
7. RESPECT each other at ALL TIMES. Refrain from talking to your neighbors when someone else
has the floor.
8. NO FOOD OR DRINKS ARE ALLOWED IN OUR CLASS.
9. You are responsible for your conduct in your other classes. If you are a behavior problem in
another class, it will be brought to my attention. You will be subject to removal from the co-op
program due to behavioral problems.
10. Park in the designated parking lot only. DO NOT park in the front of school or in the teachers’ lot.
________________________________
Parent’s Signature
________________________________
Student’s Signature
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DEPENDABILITY GRADE
An important characteristic of a good employee is dependability. It is vital that the student realize the
importance of being dependable on the job and in the classroom. To reinforce this, a
“DEPENDABILITY GRADE” has been created. It is treated as a MAJOR TEST GRADE and is
averaged in with the other major test scores.
When a student is absent from school for ANY REASON, he/she must telephone his/her Practicum
(co-op) teacher before NOON that day. If the teacher’s phone rings to voice mail, the student should
leave the following information:
Name, date, time, reason for absence, and phone number
It is the student’s responsibility to phone his/her employer to report the absence in a timely manner
from work. Practicum students are also required to sign in each day on the Practicum
Dependability Log, located in the classroom.
Practicum students are required to sign in each day on the Practicum Dependability Log!
Failure to phone the teacher in the event of an absence or to sign in when present will result in points
being deducted from the “Dependability Grade” in the following manner:
PRESENT EVERY
DAY……………………………………………………………………………..…………100%
ABSENT
CALLED IN
FAILED TO CALL or SIGN
IN
1 DAY
2 DAYS
3 DAYS***
4 DAYS
5 DAYS
97%
93%
90%
87%
83%
87%
78%
65%
37%
0
***If you are absent 3 or more continuous days, and you have a doctor’s note, you will be
exempt from this system for the period of time in which you were absent.
As you can see, it is critical that you become a dependable, responsible, young adult!
____________________________
(Parent’s signature)
______________________________
(Student’s signature)
Practicum Teacher’s Phone Number: (xxx) xxx-xxxx
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POLICIES GOVERNING UNEMPLOYED STUDENTS
1. If a student is released from a job because he/she has been found guilty of theft/unethical
conduct, the student is released from the program with no credit.
2. Students fired from jobs for reasons other than theft/unethical conduct, even though they go to
work at another job, may receive a NINE-WEEKS / SIX WEEKS (Circle one) grade of no higher
than 60 for the grading period during which they were fired.
3. Students fired from jobs are expected to find their own employment within five school days.
Grades will be reduced from the sixth day forward.
4. Students who are laid off will have ten days to find a job and the coordinator will assist them in
finding a job. Grades will be reduced from the eleventh day forward.
5. If a student quits a job without permission from the coordinator, he/she will receive a NINEWEEKS / SIX WEEKS (Circle one) grade of no higher than 60 for the grading period during which
he/she quit the job.
6. The second time a student has been fired and/or quits without permission from the coordinator,
he/she will be released from the program with loss of credit.
I understand that any time the Practicum student is not employed in an APPROVED training station;
he/she must be under the supervision of the Practicum instructor from the end of the class period
through the end of the school day, until a new training station is secured. The student may be
exempt from this restriction if he/she has a scheduled appointment for a job interview. (Documented
proof of interview is required.)
___________________________________
Parent/Guardian Signature
______________________________
Student’s Signature
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SUMMARY SIGNATURE VERIFICATION FORM
I have reviewed the following forms:
LPSCS Practicum (Co-op) Syllabus
Student Responsibilities in Cooperative Training Program
Classroom Rules
Dependability Grade
Policies Governing Unemployed Students
My signature acknowledges I have read all documents listed above and agree to abide by the stated
policies.
____________________
Parent’s Signature
_____________________
Student’s Signature
Please return this form to the teacher.
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WAGE AND HOUR REPORT
NAME/ID#
______________________________________________________
TRAINING STATION
______________________________________________________
STUDENT SIGNATURE
HOURLY WAGE $ __________________________________
TOTAL HOURS FOR 3 WEEKS __________
______________________________________________________
Your signature verifies the information on this report is accurate and honest.
WEEK
9/25-9/29
HOURS
From
WORKED
To
TOTAL
HOURS
CLASSES
MISSED
MONDAY
1 2 3
TUESDAY
1 2 3
WEDNESDAY
1 2 3
THURSDAY
1 2 3
FRIDAY
1 2 3
SATURDAY
1 2 3
SUNDAY
1 2 3
REASON FOR ABSENCE
TOTAL HOURS: MONDAY - FRIDAY
TOTAL HOURS FOR WEEK
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Name_______________________________________
Date_______________________________
Discussion Rubric
4 pts.
Excellent
Objectives
3 pts.
Good
2 pts. Needs Some
Improvement
1 pt. Needs Much
Improvement
N/A
Pts.
Participates in group discussion
Encourages others to join the
conversation
Keeps the discussion progressing
to achieve goals
Shares thoughts actively while
offering helpful recommendations to
others
Gives credit to others for their ideas
Respects the opinions of others
Involves others by asking questions
or requesting input
Expresses thoughts and ideas
clearly and effectively
Total Points (32 pts.)
Comments:
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Name______________________________________
Date_______________________________________
Individual Work Rubric
4 pts.
Excellent
Objectives
3 pts.
Good
2 pts. Needs Some
Improvement
1 pt. Needs Much
Improvement
N/A
Pts.
Follows directions
Student completed the work as directed,
following the directions given, in order and to the
level of quality indicated
Time management
Student used time wisely and remained on task
100% of the time
Organization
Student kept notes and materials in a neat,
legible, and organized manner. Information was
readily retrieved
Evidence of learning
Student documented information in his or her
own words and can accurately answer questions
related to the information retrieved
*Research/Gathering information (if relevant)
Student used a variety of methods and sources
to gather information. Student took notes while
gathering information
Total Points (20 pts.)
Comments:
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Name:____________________________________
Date:_____________________________
Presentation Rubric
4 pts.
Excellent
Objectives
3 pts.
Good
2 pts. Needs Some
Improvement
1 pt. Needs Much
Improvement
N/A
Pts.
Topic/Content
 Topic discussed completely and in-depth
 Includes properly cited sources (if used)
Creativity/Neatness
 Integrates a variety of multimedia effects to
create a professional presentation (transition
and graphics) or appropriate visual aid used
 Title slide, table of contents, bibliography are
included, using acceptable format
Mechanics
 Grammar, spelling, punctuation, and
capitalization are correct
 Image and font size are legible to the entire
audience
Oral Presentation
 Communicates with enthusiasm and eye
contact
 Voice delivery and projection are dynamic
and audible
Audience Interaction
 Presentation holds audience’s attention and
relates a clear message
 Clearly and effectively communicates the
content throughout the presentation
Total Points (20 pts.)
Comments:
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