Letter from Placement Employer

Process for Workplace Insurance for Post-Secondary Students on Unpaid Work Placements

Workplace Insurance Context:
• The Ontario Ministry of Colleges and Universities provides WSIB coverage for Student Trainees enrolled in an approved program at �Ӱ�ԭ�� University and participating in unpaid work placements with employers who have WSIB coverage.
• For placement employers without WSIB coverage, the Ministry provides private insurance for Student Trainees.
• �Ӱ�ԭ�� University has also arranged for private insurance coverage for students who attend placement opportunities that are not covered under either WSIB or Ministry’s private insurance plan. For any questions regarding this form, please contact the department of Risk and Insurance at �Ӱ�ԭ�� University at Risk@�Ӱ�ԭ��.ca
Documentation Process:
• Placement Employers must electronically file the form below with the student’s department (ICSLAC) prior to the commencement of the unpaid work/education placement.
• An email copy will be sent to the placement employer, who must keep it on file.

This field is for validation purposes and should be left unchanged.

Student Name and �Ӱ�ԭ�� Student number(Required)

First Last Student Number

Please reach out directly to the student for their �Ӱ�ԭ�� student #.

Organization's Name(Required)

Supervisor's Name and Email Contact Information(Required)

First Last Email information

Estimated Number Placement Hours(Required)

144 as requirement for either CURA 5011 or CURA 5012

288 hours as requirement for both CURA 5011 and CURA 5012

This placement applies to Graduate students registered in the Graduate Diploma in Curatorial Studies (Institute for Comparative Studies in Literature, Art and Culture, �Ӱ�ԭ�� 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).

The employer's organization is covered under the Workplace Safety & Insurance Board.(Required)

YES