Support Service General Liability

Externship Support Service Program Disclosure

Ed*Go offers students the opportunity to complete on-the-job training through externship at local and national employers. Students may be able to use the hours in training to support state or national board licensure requirements, or simply to gain additional applicable skills to bolster employability. If you are interested in participating in an Ed2Go externship support service program, please review and complete this disclosure form and submit to *****.**********@*******.***.

Student Name:

Program:

Academic Institution:

By signing this form, I am acknowledging and agreeing to the following terms: 1. Some fields require students to complete a certain number of hours of training and/or to complete specific clinical skills sets as an extern in order to be eligible for licensure in that field; however, you are not obligated to complete your externship with Ed2Go.

2. In order to be eligible for an externship, you must first complete the required didactic training portion of your program, be 18 or older, and be up to date with course payments. 3. Externships are unpaid.

4. The externship support program is not an externship placement program. 5. Our externship partners require a background check and drug screen prior to an externship placement. You understand that in order to participate, you may be required to complete both types of checks prior to starting your externship. If you have any concerns that these checks will reveal negative information, please speak to an Externship Coordinator.

6. A negative background or drug screen can limit your opportunities for externship, and in some cases, may also impact the ability to achieve licensure and employment. You should carefully consider whether a licensure program is going to fulfill your educational goals if you have anything in your record. 7. You will be required to carry your own health insurance, and, in some cases, you will also need to carry a general liability policy as requested by the externship partner. 8. You will be required to name the Externship Coordinator at Ed2go as a recipient of any general liability policy cancellation notices.

9. Many externship partners are requesting evidence of immunizations, including a COVID vaccination, in in order to be considered eligible for externship. You understand that you may be unable to complete externship without evidence of these vaccinations, unless you qualify for a legal exemption granted by the externship site.

10. Completing an externship is not a guarantee of employment by the training partner, nor will it guarantee you are eligible for licensure.

Check the box below to indicate whether you would like to work with Ed2Go to facilitate an externship opportunity.

Yes, I would love Ed2Go to assist me. No, I will arrange my own externship. I understand and agree to the terms above. Signed on by:

Tammy pratt

Tammy pratt

04/03/2024

Phlebotomist

Student signature

Contact this candidate