PORT CREDIT SECONDARY SCHOOL
CO-OPERATIVE EDUCATION
COP2XC - 2 CREDITS
COP 4XC - 4 CREDITS
PLEASE RETURN THIS APPLICATION ALONG WITH A CURRENT
RESUME TO THE GUIDANCE ASSISTANT BY APRIL 7, 2015.
Personal Information:
Student’s Name (Surname, First name)
______________________________________
Address:______________________________
______________________________________
Phone #:______________________________
# Credits
Earned to date
Birthdate ____________________________
Age _____
_________
Email Address:
_________________________
Student ID #
_______________
Co-op Schedule: Full Day or Afternoon
M / F (circle one)
Career Interests:
Over 5000 employers exist in the Peel District School Board database that may be a match to your type of personality
skills and work interests. Select any of the following career choices for a possible placement of interest to you.
PLEASE CIRCLE CAREER CHOICES THAT INTEREST YOU AND INDICATE 1ST AND 2ND CHOICE :
Aesthetics
Food Industry
OYAP (Ontario Youth Apprenticeships)
Business
Law & Security
Retail
Child Care/Teaching
Logistics (Warehouse)
Sports/Athletics
Computers (IT)
Medical & Health Clinics
Travel & Tourism
Entrepreneurship
Music & Arts Industry
Trades (motive/construction/service/industrial)
Other (Please list your specific occupation choices from the above categories here (indicate 1st and 2nd choice) and If you have your own
placement, put the company name here):________________________________________________________________________________
OR CIRCLE CENTRAL OR REGIONAL PROGRAMS YOU LIKE:
These require specialized applications, essays, and interviews, more commitment of your time & transportation costs.
These placements are subject to availability each semester and have a strict deadline!
Brampton Courts (4 credit only)
City of Mississauga: Fitness, Info. Tech., Environment
Peel Regional Police (4 credit only)
Citizenship and Immigration Canada
Speigel Nichols Fox LLP: Law
Mississauga News: Journalism and Photography
Donato Salon: Hair and Make-up
Lexsan Electrical (4 credit only)
Metroland South Media Group: Marketing Asst., Digital Production Coordinator
PLASP: Administrative Assistant and Nursery School Assistant
Rogers TV (Mississauga): Producer’s Assistant and Production Crew Member
Trillium Health Partners: Credit Valley, Mississauga, and Queensway Health Centre
Dual Credit Programs – George Brown, Humber, Seneca College and Sheridan.
**Sheridan - i.e. Trades, Robotics, Justice, Animal Grooming and Animal Science, Performing Arts, Media Fundamentals, ECE, Fitness
**Humber – i.e. Animation, Psychology, Intro. To Spa Management, ECE, Film & TV, Trades, Home Reno., Cook **George Brown - i.e. Digital Art and
Design, Psychology, Baking and Pastry **Seneca– i.e. Leadership, Sociology, Film and TV, Digital Design, Event Mgmt., Child Development
Please see Co-op teachers if you are interested in learning more about the dual credit programs available.
Transportation:
How far are you willing to travel for your placement? (circle one)
1. Anywhere in Mississauga
2. Anywhere in the G.T.A.
3. Walking Distance
How will you get to your placement? (circle any that apply)
1. Walk
2. Mississauga Transit
Drive with Parent / Relative who works in placement area.
The more we know, the better we can match you to the perfect job! Please complete these questions.
1. List the skills, interests, personal qualities, and extra-curricular experiences that you can offer to an employer.
______________________________________________________________________________________________
______________________________________________________________________________________________
2. Describe your volunteer activities or part-time jobs (include # of hours worked each week). ____________________
______________________________________________________________________________________________
3. List Awards/Certificates of Achievement you have earned, both in and out of school in sports, academics,
attendance, Driver’s Ed., First Aid, Passport to Safety, martial arts, swimming, dance, etc. ____________________
______________________________________________________________________________________________
4. How is your attendance? (Circle one)
Excellent
How is your punctuality? (Circle one)
Excellent
5. What are your plans after you graduate? (Circle one)
Good
Fair
Good
College
Fair
Could be better
Could be better
University Apprenticeship Work
6. Are you planning on participating in any extracurricular activities at P.C.S.S.? (Circle one) Y/N
7. Why do you want to take Co-op, or what do you hope to learn from the experience?__________________________
______________________________________________________________________________________________
_________________________________________________________________________________________________________
_______________________________________________________________________________________________
References: List ONE teacher reference and have them sign below:
Teacher’s Name (print)
Teacher’s Signature
Comments
Approval: PARENTS/GUARDIANS SHOULD BE AWARE THAT EACH STUDENT:
1.
2.
3.
4.
5.
6.
Will be interviewed by the prospective employer.
Is encouraged by the Peel District School Board to use public transportation to and from the placement.
If own (personal/family) vehicles are used:
The student must have the appropriate classification of driver’s license and car insurance.
The primary insurer is the owner’s insurance.
The insurer of the vehicle must respond to any insurance claim.
Will be covered, while at the co-op placement, under the Workers’ Compensation Act by WSIB.
Will work only the hours as specified on the Ministry of Education Work Education Agreement.
Will declare to the Co-op teacher any medical condition that may affect their placement.
I am aware that the information contained in this application will be used for purposes consistent with the Education Act.
___________________________________________
Student’s Signature
______________________________________
Date
___________________________________________
Parent/Guardian’s Signature (If under 18)
______________________________________
Date