Agency Registration - Community Studies

If you would like to become Community partner with Mohawk College for the purpose of hosting one of our students for an unpaid student field placement please complete the following form.

Is this a new registration or an update?

Agency Information

If so what is the name of the organization

Contact Information

List any other people who may wish to be listed as contacts for your agency. Please include a phone number and email address.

Student Placement Agreement/Affiliation Agreement

The Student Placement Agreement/Affiliation Agreement  is the mandatory agreement between your Agency and Mohawk College in order to secure a student with your Agency. The purpose of the agreement is to outline the responsibilities and expectations of both you as a Community Partner, the College and the student. One Agreement covers all student placements.

Do you have an active Student Placement Agreement/Affiliation Agreement with Mohawk College?

WSIB

    
Students completing an unpaid work placement are covered under either  the Workplace Safety and Insurance Board (WSIB) or private insurance  coverage CHUBB provided via the Ministry of Advanced Educaton and Skills Development (MAESD), depending on the Placement Employer’s coverage.  If the assigned agency is not covered under WSIB the student will be covered under CHUBB, otherwise, students are covered by WSIB. For more information regarding this process visit: http://www.tcu.gov.on.ca/pepg/publications/placement.html 

Is your workplace covered by WSIB?

Placement Information

What are your core services and clientele?
Please list any specific programs that you have within your agency/organization.
What are some of the activities that a student might be involved in while on field placement with your agency?
Typical Student Shifts
i.e. Police Check, First Aid etc.
Which Mohawk Programs are you interested in hosting students from?

Thank you

If you are interested in speaking with one of our Field Placement Specialists, please contact one of the following

Brain Disorders Management
Anita O'Keeffe anita.okeeffe [at] mohawkcollege.ca (anita[dot]okeeffe[at]mohawkcollege[dot]ca) ext. 3573

Child & Youth Care
Sean Flaherty sean.flaherty [at] mohawkcollege.ca (anita[dot]okeeffe[at]mohawkcollege[dot]ca) ext. 3453
Ken Brill ken.brill [at] mohawkcollege.ca (ken[dot]brill[at]mohawkcollege[dot]ca) ext.

CICE
Stacey Money  stacey.money [at] mohawkcollege.ca (stacey[dot]money[at]mohawkcollege[dot]ca)  905-575-1212 ext. 4077

Concurrent Disorders
Anita O'Keeffe anita.okeeffe [at] mohawkcollege.ca (anita[dot]okeeffe[at]mohawkcollege[dot]ca) ext. 3573

Early Childhood Education
Karen Shurvin karen.shurvin [at] mohawkcollege.ca (karen[dot]shurvin[at]mohawkcollege[dot]ca) ext. 4374
Maria Agro maria.agro [at] mohawkcollege.ca (maria[dot]agro[at]mohawkcollege[dot]ca) ext. 4176
Melanie Graham melanie.graham [at] mohawkcollege.ca (melanie[dot]graham[at]mohawkcollege[dot]ca) ext. 3252

Educational Support
Stacey Money stacey.money [at] mohawkcollege.ca (stacey[dot]money[at]mohawkcollege[dot]ca) ext. 4077

Mental Health & Disability Management
Anita O'Keeffe anita.okeeffe [at] mohawkcollege.ca (anita[dot]okeeffe[at]mohawkcollege[dot]ca) ext. 3573

Social Service Worker
Vicky Webb vicky.webb [at] mohawkcollege.ca (vicky[dot]webb[at]mohawkcollege[dot]ca) ext. 3363
Lucas Reniers lucas.reniers [at] mohawkcollege.ca (lucas[dot]reniers[at]mohawkcollege[dot]ca) ext. 3717