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SDCCD Work Experience - Alt Site Visit Fall 2021
REQUEST MUST BE SUBMITTED AND APPROVED BY DEAN BEFORE SEMESTER ADD/DROP DATE
Questions or need accommodations? Please contact
sfawcett@sdccd.edu
to contact the Work Experience Coordinator for more information.
COURSE INFORMATION
Campus:
*
City
Mesa
Miramar
Academic Term & Year:
*
Please select
Fall 2021
Work Experience Course:
*
Please select the Work Experience course requesting an Alternate Site Visit:
CACM 270 - 2 Units - McCormack, B. - Class # 76542- 14 WK: 9/6 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
CHIL 270 - 2 Units - George, M. - Class # 76452 - 16 WK: 8/23 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
CHIL 270 - 3 Units - George, M. - Class # 76453 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
CHIL 270 - 4 Units - George, M. - Class # 76454 - 16 WK: 8/23 - 12/18/21 - Hours: 240 Unpaid | 300 Paid
EXSC 270 - 1 Unit - Portugal, J. - Class # 75676 - 16 WK: 8/23 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
EXSC 270 - 1 Unit - Portugal, J. - Class # 76736 - 12 WK: 9/20 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
FASH 270 - 2 Units - Hoffmire, L. - Class # 71847 - 16 WK: 8/23 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
FASH 270 - 3 Units - Hoffmire, L. - Class # 71848 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
FASH 270 - 2 Units - Hoffmire, L. - Class # 72059 - 14 WK: 9/7 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
GIS 270 - 1 Unit - Russell, R. - Class # 75678 - 16 WK: 8/23 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
GIS 270 - 2 Units - Russell, R. - Class # 75679 - 16 WK: 8/23 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
GIS 270 - 3 Units - Russell, R. - Class # 75680 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
GIS 270 - 2 Units - Russell, R. - Class # 76745 - 12 WK: 9/20 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
HOSP 270 - 1 Unit - Lizano, A. - Class # 75681 - 16 WK: 8/23 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
HOSP 270 - 2 Units - Lizano, A. - Class # 75682 - 16 WK: 8/23 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
HOSP 270 - 3 Units - Lizano, A. - Class # 71244 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
INTE 270 - 3 Units - Hines, J. - Class # 71849 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
INTE 270 - 4 Units - Hines, J. - Class # 75683 - 16 WK: 8/23 - 12/18/21 - Hours: 240 Unpaid | 300 Paid
INTE 270 - 3 Units - Hines, J. - Class # 76737 - 12 WK: 9/20 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
NUTR 270 - 1 Unit - Woods, A - Class # 71850 - 16 WK: 8/23 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
NUTR 270 - 3 Units - Woods, A. - Class # 71630 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
NUTR 270 - 4 Units - Woods, A. - Class # 71145 - 16 WK: 8/23 - 12/18/21 - Hours: 240 Unpaid | 300 Paid
NUTR 270 - 1 Unit - Woods, A - Class # 76729 - 13 WK: 9/13 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
SUST 270 - 1 Unit - Ray, W. - Class # 75998 - 16 WK: 8/23 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
SUST 270 - 3 Units - Ray, W. - Class # 76451 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
VTAH 270 - 3 Units - McNabb, D. - Class # 71553 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
WORK 270 - 1 Unit - Consuegra, P. - Class # 75684 - 16 WK: 8/23 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
WORK 270 (Hoover HS Only) - 1 Unit - Manasse, M. - Class # 72055 - 16 WK: 8/23 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
WORK 270 - 2 Units - Hoffmire, L. - Class # 76457 - 16 WK: 8/23 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
WORK 270 - 3 Units - Fawcett, S. - Class # 72053 (AFT Mentor Program) - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
WORK 270 - 4 Units - Cook, C. - Class # 71245 - 16 WK: 8/23 - 12/18/21 - Hours: 240 Unpaid | 300 Paid
WORK 270 - 3 Units - Cook, C. - Class # 71247 - 12 WK: 9/20 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
WORK 270 - 1 Unit - Hoffmire, L. - Class # 71249 - 8 WK: 10/18 - 12/18/21 - Hours: 60 Unpaid | 75 Paid
WORK 272 - 3 Units - Hoffmire, L. - Class # 71254 - 16 WK: 8/23 - 12/18/21 - Hours: 180 Unpaid | 225 Paid
WORK 272 - 2 Units - Cook, C. - Class # 71255 - 12 WK: 9/20 - 12/18/21 - Hours: 120 Unpaid | 150 Paid
Work Experience credit is awarded based on 75 hours of paid work/internship or 60 hours of unpaid internship per unit the student is enrolled. View the
Work Experience Student Handbook (Page 13)
for minimum hours required per semester by unit.
Instructor Name:
*
STUDENT INFORMATION
Instructor Email:
*
Student Name:
*
First
Last
CSID:
*
Student Phone:
*
###
-
###
-
####
Student Email:
*
Student Position Title:
*
Student Type of Work:
*
Paid
Unpaid
EMPLOYER/ORGANIZATION INFORMATION
Company/Organization Name:
*
Address:
*
Worksite Address:
(if different than company address)
Site Supervisor Name:
*
Site Supervisor Title:
*
Site Supervisor Phone:
*
###
-
###
-
####
Site Supervisor Email:
*
REQUESTED ALTERNATIVE
Mark all alternative site visit tools that will be used:
*
Phone
Email
Internet (Skype, Zoom, FaceTime, etc.)
Partner with instructors from another college
Other
JUSTIFICATION
Provide rationale for selection and use of alternative site visit method(s):
*
WORK EXPERIENCE INSTRUCTOR REQUESTER SIGNATURE
Signature
*
Clear
Please use your computer mouse cursor or finger on a tablet to physically sign your name as you would for a wet signature.
Date
*
MM
/
DD
/
YYYY
