{"id":699,"date":"2022-04-11T15:56:53","date_gmt":"2022-04-11T19:56:53","guid":{"rendered":"https:\/\/carleton.ca\/curatorial-studies\/?page_id=699"},"modified":"2022-04-11T16:00:00","modified_gmt":"2022-04-11T20:00:00","slug":"letter-to-placement-employer-2","status":"publish","type":"page","link":"https:\/\/carleton.ca\/curatorial-studies\/letter-to-placement-employer-2\/","title":{"rendered":"Letter from Placement Employer"},"content":{"rendered":"<script type=\"text\/javascript\">var gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,initializeOnLoaded:function(o){gform.domLoaded&&gform.scriptsLoaded?o():!gform.domLoaded&&gform.scriptsLoaded?window.addEventListener(\"DOMContentLoaded\",o):document.addEventListener(\"gform_main_scripts_loaded\",o)},hooks:{action:{},filter:{}},addAction:function(o,n,r,t){gform.addHook(\"action\",o,n,r,t)},addFilter:function(o,n,r,t){gform.addHook(\"filter\",o,n,r,t)},doAction:function(o){gform.doHook(\"action\",o,arguments)},applyFilters:function(o){return gform.doHook(\"filter\",o,arguments)},removeAction:function(o,n){gform.removeHook(\"action\",o,n)},removeFilter:function(o,n,r){gform.removeHook(\"filter\",o,n,r)},addHook:function(o,n,r,t,i){null==gform.hooks[o][n]&&(gform.hooks[o][n]=[]);var e=gform.hooks[o][n];null==i&&(i=n+\"_\"+e.length),gform.hooks[o][n].push({tag:i,callable:r,priority:t=null==t?10:t})},doHook:function(n,o,r){var t;if(r=Array.prototype.slice.call(r,1),null!=gform.hooks[n][o]&&((o=gform.hooks[n][o]).sort(function(o,n){return o.priority-n.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==n?t.apply(null,r):r[0]=t.apply(null,r)})),\"filter\"==n)return r[0]},removeHook:function(o,n,t,i){var r;null!=gform.hooks[o][n]&&(r=(r=gform.hooks[o][n]).filter(function(o,n,r){return!!(null!=i&&i!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][n]=r)}});<\/script>\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_2' >\n                        <div class='gform_heading'>\n                            <h3 class=\"gform_title\">Letter from Placement Employer<\/h3>\n                            <p class='gform_description'><b>Process for Workplace Insurance for Post-Secondary Students on Unpaid Work Placements<\/b><br><br><b>Workplace Insurance Context:<\/b><br>\r\n\u2022 The Ontario Ministry of Colleges and Universities provides WSIB coverage for Student Trainees enrolled in an approved program at Carleton University and participating in unpaid work placements with employers who have WSIB coverage.<br>\r\n\u2022 For placement employers without WSIB coverage, the Ministry provides private insurance for Student Trainees.<br>\r\n\u2022 Carleton University has also arranged for private insurance coverage for students who attend placement opportunities that are not covered under either WSIB or Ministry\u2019s private insurance plan. For any questions regarding this form, please contact the department of Risk and Insurance at Carleton University at &#82;i&#x73;k&#x40;C&#x61;&#114;&#x6c;&#101;&#x74;&#111;n&#x2e;c&#x61;<br>\r\n<b>Documentation Process:<\/b><br> \r\n\u2022 Placement Employers must electronically file the form below with the student's department (ICSLAC) prior to the commencement of the unpaid work\/education placement. <br>\r\n\u2022 An email copy will be sent to the  placement employer, who must keep it on file. <\/p>\n                        <\/div><form method='post' enctype='multipart\/form-data'  id='gform_2'  action='\/curatorial-studies\/wp-json\/wp\/v2\/pages\/699' data-formid='2' >\n                        <div class='gform-body gform_body'><ul id='gform_fields_2' class='gform_fields top_label form_sublabel_below description_below'><li id=\"field_2_1\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_1\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Student Name and Carleton Student number<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name has_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_2_1'>\n                            \n                            <span id='input_2_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_2_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_2_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_2_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_2_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_2_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <span id='input_2_1_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.8' id='input_2_1_8' value=''   aria-required='false'     \/>\n                                                    <label for='input_2_1_8' class='gform-field-label gform-field-label--type-sub '>Student Number<\/label>\n                                                <\/span>\n                        <\/div><div class='gfield_description' id='gfield_description_2_1'>Please reach out directly to the student for their Carleton student #.<\/div><\/li><li id=\"field_2_4\"  class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_4\"><label class='gfield_label gform-field-label' for='input_2_4' >Organization&#039;s Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_2_4' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/> <\/div><\/li><li id=\"field_2_26\"  class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_26\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Supervisor&#039;s Name and Email Contact Information<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name has_suffix gf_name_has_3 ginput_container_name gform-grid-row' id='input_2_26'>\n                            \n                            <span id='input_2_26_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_26.3' id='input_2_26_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_2_26_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_2_26_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_26.6' id='input_2_26_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_2_26_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            <span id='input_2_26_8_container' class='name_suffix  gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_26.8' id='input_2_26_8' value=''   aria-required='false'     \/>\n                                                    <label for='input_2_26_8' class='gform-field-label gform-field-label--type-sub '>Email information<\/label>\n                                                <\/span>\n                        <\/div><\/li><li id=\"field_2_34\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_34\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Estimated Number Placement Hours<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_34'><li class='gchoice gchoice_2_34_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.1' type='checkbox'  value='144 as requirement for either CURA 5011 or CURA 5012'  id='choice_2_34_1'   aria-describedby=\"gfield_description_2_34\"\/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_1' id='label_2_34_1' class='gform-field-label gform-field-label--type-inline'>144 as requirement for either CURA 5011 or CURA 5012<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_34_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_34.2' type='checkbox'  value='288 hours as requirement for both CURA 5011 and CURA 5012'  id='choice_2_34_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_34_2' id='label_2_34_2' class='gform-field-label gform-field-label--type-inline'>288 hours as requirement for both CURA 5011 and CURA 5012<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><div class='gfield_description' id='gfield_description_2_34'>This placement applies to Graduate students registered in the Graduate Diploma in Curatorial Studies (Institute for Comparative Studies in Literature, Art and Culture, Carleton University) as part of their practicum course requirements. Please indicate whether the estimated number of hours covers a single course (either CURA 5011 or CURA 5012) or both (CURA 5011 and CURA 5012, taken consecutively over two academic terms).<\/div><\/li><li id=\"field_2_33\"  class=\"gfield gfield--type-checkbox gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_33\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >The employer&#039;s organization is covered under the Workplace Safety &amp; Insurance Board.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_checkbox'><ul class='gfield_checkbox' id='input_2_33'><li class='gchoice gchoice_2_33_1'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.1' type='checkbox'  value='YES'  id='choice_2_33_1'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_1' id='label_2_33_1' class='gform-field-label gform-field-label--type-inline'>YES<\/label>\n\t\t\t\t\t\t\t<\/li><li class='gchoice gchoice_2_33_2'>\n\t\t\t\t\t\t\t\t<input class='gfield-choice-input' name='input_33.2' type='checkbox'  value='NO'  id='choice_2_33_2'   \/>\n\t\t\t\t\t\t\t\t<label for='choice_2_33_2' id='label_2_33_2' class='gform-field-label gform-field-label--type-inline'>NO<\/label>\n\t\t\t\t\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_2_25\"  class=\"gfield gfield--type-consent gfield--type-choice gfield_contains_required field_sublabel_below gfield--has-description field_description_below gfield_visibility_visible\"  data-js-reload=\"field_2_25\"><label class='gfield_label gform-field-label gfield_label_before_complex'  >Declaration<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_consent'><input name='input_25.1' id='input_2_25_1' type='checkbox' value='1'  aria-describedby=\"gfield_consent_description_2_25\" aria-required=\"true\" aria-invalid=\"false\"   \/> <label class=\"gform-field-label gform-field-label--type-inline gfield_consent_label\" for='input_2_25_1' >I agree to the following (in lieu of signature)<\/label><input type='hidden' name='input_25.2' value='I agree to the following (in lieu of signature)' class='gform_hidden' \/><input type='hidden' name='input_25.3' value='5' class='gform_hidden' \/><\/div><div class='gfield_description gfield_consent_description' id='gfield_consent_description_2_25'>By checking the box above in lieu of signature of an authorized representative, the Placement Employer hereby agrees to the following: <br \/>\nThat it will immediately report to the department of Risk and Insurance at Carleton University at &#x52;&#105;s&#x6b;&#x40;&#67;a&#x72;&#x6c;&#101;t&#x6f;&#110;&#46;&#x63;&#x61; or 613-520-2600 and the departmental co-ordinator any workplace injury or disease involving a student on an unpaid work placement and: <br \/>\n\u2022 Where the Placement Employer is covered by the WSIB, the Placement Employer will comply with all WSIB reporting procedures. <br \/>\n\u2022 If the Placement Employer is not covered by the WSIB, then it will comply with the Ministry\u2019s private insurer\u2019s reporting procedures found in the Ministry\u2019s \u201cGuidelines for Workplace Insurance for Post-Secondary Students of Publicly Assisted Institutions on Unpaid Work Placements\u201d at: http:\/\/www.tcu.gov.on.ca\/pepg\/publications\/placement.html <br \/>\n\u2022 When the Placement Employer is covered under the Workplace Safety and Insurance Act, a Form 7 and a Letter of Authorization to Represent the Placement Employer will be completed and submitted to Robin Karuna, WSIB Program Administrator at Carleton University at &#x52;&#111;&#98;i&#x6e;&#x2e;&#75;a&#x72;&#x75;&#110;a&#64;&#x43;&#97;&#114;l&#x65;&#x74;&#111;n&#x2e;&#x63;&#97; within three days of learning of a work-related accident. <br \/>\nThe Placement Employer agrees that it will provide the Student Trainee with health and safety training and take appropriate precautions to ensure that the Student Trainee is supervised in order to protect the Student Trainee from health and safety hazards that may be encountered at the placement organization, as required under the Occupational Health and Safety Act. <br \/>\nIn the event of a claim, the Placement Employer agrees that it will review the Student Trainee\u2019s restrictions and,where possible, modify the program as required in order to accommodate the Student Trainee to facilitate return to the program. <br \/>\n<\/div><\/li><li id=\"field_2_35\"  class=\"gfield gfield--type-honeypot gform_validation_container field_sublabel_below gfield--has-description field_description_below 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