Form 5 - Field Placement Form
18
1 of 18 PEPA_5 10/2019 Paralegal Education Program Accreditation 130 Queen Street West Toronto, Ontario, M5H 2N6 T: 416-947-3300 LSO.ca/accreditedprograms [email protected] PARALEGAL EDUCATION PROGRAM ACCREDITATION Form 5—Field Placement Form Submit this form to: [email protected] Campus(es): Program Credential: Province: Postal Code: Date: (MM/DD/YY): Institution Name: Program Name: Program Address: City: Telephone: Email: Applicant Institutions must attach confirmation letters from a representation of Field Placement Hosts and Field Placement Supervisors to their Form 5 submission. These letters should confirm a formal field placement arrangement between the Institution and the Field Placement Host and should be written on the Field Placement Host’s letterhead. The Law Society may contact Field Placement Hosts to confirm that such an agreement exists. Institutions must also include with this Form 5 a copy of the field placement policy. Total number of field placement hours required: Timing of field placement: 1. Field Placement Host Business Name: Name of Field Placement Supervisor: Supervisor Contact Number: Nature of Legal Organization: Student Duties: Number of Students Placed/Intended to be Placed Annually with Business:
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Transcript of Form 5 - Field Placement Form
1 of 18
PEPA_5 10/2019
Paralegal Education Program Accreditation 130 Queen Street West Toronto, Ontario, M5H 2N6
T: 416-947-3300 LSO.ca/accreditedprograms [email protected]
PARALEGAL EDUCATION PROGRAM ACCREDITATION Form 5—Field Placement Form
Submit this form to: [email protected]
Campus(es):
Program Credential:
Province: Postal Code:
Date: (MM/DD/YY):
Institution Name:
Program Name:
Program Address:
City:
Telephone: Email:
Applicant Institutions must attach confirmation letters from a representation of Field Placement Hosts and Field Placement Supervisors to their Form 5 submission. These letters should confirm a formal field placement arrangement between the Institution and the Field Placement Host and should be written on the Field Placement Host’s letterhead. The Law Society may contact Field Placement Hosts to confirm that such an agreement exists. Institutions must also include with this Form 5 a copy of the field placement policy.
Total number of field placement hours required: Timing of field placement:
1. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
FORM 5—FIELD PLACEMENT FORM
2. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
3. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
4. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
5. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
6. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
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Number of Students Placed/Intended to be Placed Annually with Business:
FORM 5—FIELD PLACEMENT FORM
7. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
8. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
9. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
10. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
11. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
12. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
13. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
14. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
15. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
16. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
17. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
18. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
19. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
20. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
21. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
22. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
23. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
24. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
25. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
26. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
27. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
28. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
29. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
30. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
31. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
32. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
33. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
34. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
35. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
36. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
37. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
38. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
39. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
40. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
41. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
42. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
43. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
44. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
45. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
46. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
47. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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FORM 5—FIELD PLACEMENT FORM
48. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
49. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
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50. Field Placement Host Business Name:
Name of Field Placement Supervisor:
Supervisor Contact Number:
Nature of Legal Organization:
Student Duties:
Number of Students Placed/Intended to be Placed Annually with Business:
