Cooperative Education Registration Form
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1. Default Section

 

1. Contact Information

2. Residence Status

3. Campus Box # (if applicable)

4. Please enter your HOME address information

5. Please enter the phone number and email address that is best to reach you.

6. Please enter information for an Emergency Contact in the event we need to reach someone on your behalf.

7. Major

8. Expected Graduation Year

9. Are you a United States Citizen?

Before clicking submit read the Student Agreement Form below. Your participation in the Co-op Program is guided by this agreement. Once you click submit make sure to print a copy of the agreement for your records.
STUDENT CO-OP AGREEMENT

The Cooperative Education Program (Co-op) at Widener University is an academically based optional program that assists participating students in identifying qualified positions. In addition to all Widener University policies and procedures, as a student enrolled in the Cooperative Education Program I agree to the following:

1. The University does not guarantee a position, nor does it assign a student to a specific position. Students are ultimately responsible for obtaining a position for the Co-op program. Students must participate actively with the co-op office throughout the entire process.
2. I will be bound by all Co-op policies and procedures outlined in the Student Co-op Handbook including, but not limited to: (1) meeting all required deadlines and program requirements, (2) submitting all required forms and evaluations, (3) acting in a professional and ethical manner. Failure to follow these policies or procedures may result in dismissal from the program.
3. I understand that I must be a full-time student and maintain an overall grade point average of at least 2.20 in the School of Engineering or 2.50 in the School of Business Administration or in the College of Arts and Sciences majoring in Computer Science or Computer Information Systems.
4. I understand that I must meet academic credit minimums and maximum levels, outlined in the Co-op Student Handbook, prior to seeking a position for a given co-op term.
5. I understand that I may pursue my own co-op position with the following requirements: (1) I must notify the Co-op Office of such intentions prior to the distributing of resumes, (2) coordinate these efforts with the Co-op Office, (3) the position must be full-time, paid, and related to my major, (4) the position is subject to the same rules and regulations as a position obtained through the Co-op Office.
6. I understand that it my responsibility to investigate and learn information about a potential employer. Final acceptance of a position, including all terms and conditions proposed by the employer, is my decision.
7. My acceptance of a co-op position constitutes a contract with the hiring organization for the agreed upon terms and conditions of the position.
8. I will contact the Co-op Office if any aspects of the position change that are inconsistent with the agreed upon terms and conditions, or if the duties or environment become a hazard to my mental or physical well being.
9. I understand that the employer may terminate me if I am performing unsatisfactorily, judged incompetent of performing my work, irregular in attendance or punctuality, or fail to cooperate in a reasonable manner. This will also result in dismissal from the Co-op Program and a grade of "Not Successfully Completed".
10. I have the right to appeal decisions made by the Director of the Co-op Program to the Assistant Provost, School Dean, or Academic Review Committee.
11. I acknowledge that I am responsible for paying all local, state, and federal income taxes as well as submitting appropriate tax forms according to the IRS, state, and local tax collection agencies.
12. I understand that my eligibility and responsibility for applying for unemployment compensation is determined by the state in which I was employed for the co-op period.
13. By entering into this Student Co-op Agreement, I consent and authorize the issuance of my resume and official transcripts that may be requested or required by prospective co-op employers.
14. I understand that if I am not a United States citizen or permanent resident, that I will obtain proper work authorization through the International Student Services Office prior to beginning employment for a co-op term.
15. I agree to indemnify, defend, and hold harmless the University; its servants, agents, and employees and any persons acting as such, from any and all liability, advantage, expense, causes of action, suits, claims, or judgments arising from injury to person(s) or personal property or otherwise in connection with my participation in or arising out of my employment by the co-op employer.
16. During the term of employment of the Student by the co-op employer, Student shall be considered a full-time employee of employer and shall be subject to coverage under applicable workers compensation laws of the state in which the place of employment is located. Employer’s liability to students for accident or injury on the job may be limited by the applicable employment. Students are advised to familiarize themselves with such workers compensation laws and their rights thereunder.
17. I understand that if I do not complete all required components of the Co-op program, as defined in the orientation and Handbook, I will receive a 'Not Successfully Completed' on my academic transcript.

I acknowledge that I have read and fully understand the terms and conditions of this Student Co-op Agreement and intend to be legally bound thereby.

10. By completing the following section you agree to all the above terms of the Co-op program.