GEORGE BROWN COLLEGE COMMUNITY WORKER PROGRAM FIELD PLACEMENT

LEARNING CONTRACT & PERFORMANCE EVALUATION FORM

The purpose of this learning contract is to set the Community Worker-in-Training’s goals and tasks at the placement
organization and, upon completion of each 200 hours with the organization, evaluate the Community Worker-in-
Training’s performance.
Sivert Das 1/31/24

(Community Worker-in-Training’s Name) (Date Learning Contract Signed)

Maggie Laidlaw 647-528-3250

(Supervisor) (Tel)
Standing Up For Racial Justice

(Organization/Agency)
William Payne

(Faculty Advisor)

(Placement Supervisor’s Signature) (Date Evaluation Submitted)

Overview of Placement (To be completed by Community Worker-in-Training)

Please provide a brief overview of the placement setting and the scope of the Community Worker-in-Training’s level of involvement, learning
opportunities, and extent of responsibilities. I.e. this may draw on the placement listing information and will help establish the context for the
Community Worker-in-Training’s performance evaluation.

My placement is at Standing Up For Racial Justice(Surj) and I am a placement student that works primarily in the role of assisting Surj members with their events such
as, running discussions, creating post event emails and debriefs and helping during protests and movements. I also will be running and facilitating discussion with my
fellow placement students about organizing and will be creating, organizing and leading my own events surrounding Palestine and Disability and Racial justice. If there
is an incident with a Surj member, I am being trained to intervene and call the person in instead of calling them out. I will be organizing and leading an event myself and
in that way, will be intrically involved in Surj based around educating members and others about the intersectionality of race and disability. This will lead to oppertunities
for Surj to understand and deepen their own AOP practice and create methods for attendees to make space for the community to have a discussion about this
particular struggle. Myself and the other Surj Placement students are also discussing creating events for the people of Palestine to create space for Palestinians to
openly discuss their perspectives. We are discussing bringing this to George Brown alongside Surj. I will also debrief with my fellow placement students and lead and
facilitate presentations and discussions about organizing social movements which will only help me learn how to create and educate and organize will help me in the
future create and organize social justice movements. I will also help by showing up for protests and movements held by Surj in conjunction with other organizations
including Jews Against Genocide.

Community Worker Program – George Brown College

Field Placement Goal #1 (developed by the Community Worker-in-Training in consultation with the
supervisor): To Learn how to organzie Advocacy events

Tasks to be completed to achieve this goal Community Worker-in-Training reflection on

professional learning
Join and participate in Surj led advocacy events such as, protests and
discussion groups.

Inquire as to the how I can use Surj's resources to spearhead my

organizational skills

Learn what organizing is and the best way to do it in an anti opressive way for
example, including intersectionality and ensuring that no communities are
being explictly excluded.

collaberate with others in Surj and finding allies in organizing these events,
finding

Learn how Surj organizes their events and how they define advocacy and
organizing

Supervisor’s evaluation at end of 200 hours: How well did the Community Worker-in-Training achieve
this goal?

Please circle one: Comments:

1. Exemplary community work
practice: a colleague more
than a student

2. Competent practice

3. Beginning to show competence

4. Not yet ready for practice

Field Placement Goal #2 (developed by the Community Worker-in-Training in consultation with the
To learn how to work within an anti racist organization
supervisor):

Tasks to be completed to achieve this goal Community Worker-in-Training reflection on

professional learning
Learn how Surj works as an anti racist organization and how they fit within the
larger movements

further my education around anti racism and anti opressive practices

liase with different organizations such as Jews Against Genocide that work
with Surj and understand how they approach anti racism.

discuss anti racism practices with other members of Surj, my fellow placement
students and create and open discussions with them to better understand
what an organization with an anti racist perspective looks like.

Come up with my own version of an Anti racist practice and see if we can
implement it in Surj in some capacity

Supervisor’s evaluation at end of 200 hours: How well did the Community Worker-in-Training achieve
this goal?

Please circle one: Comments:

1. Exemplary community work
practice: a colleague more
than a student
2. Competent practice
3. Beginning to show competence
4. Not yet ready for practice
Field Placement Goal #3 (developed by the Community Worker-in-Training in consultation with the
To learn how to create and run events deticated to educating and discussing AOP topics.
supervisor):

Tasks to be completed to achieve this goal Community Worker-in-Training reflection on

professional learning
Come up with an idea of what I would like to achieve and what supports are
needed to facilitate such an event

Find collaberators within Surj who might be interested in collaberating with me

on this event

Create a schedule and Think about what you need to be able to run your
event, for example:What do you need to learn (about SURJ, event running)
and how I want to place it,

To discuss with members of Surj how best to promote this event to people out
Surj to ensure optimal attendence

Learn the ins and outs how my AOP perspective and training can be used to
create the most welcoming and informative experience for attendees.

Supervisor’s evaluation at end of 200 hours: How well did the Community Worker-in-Training achieve
this goal?

Please circle one: Comments:

1. Exemplary community work
practice: a colleague more
than a student
2. Competent practice
3. Beginning to show competence
4. Not yet ready for practice
Field Placement Goal #4: To function within the placement in a professional manner

Tasks to be completed to achieve this goal Community Worker-in-Training reflection on

professional learning
Give supervisor(s) a copy of the Community Worker
Field Placement Handbook, and duplicate copies of the
registration and insurance forms, Learning Contract,
and completed monthly time sheets
Attend regularly, be punctual, notify organization of
absences, and arrange for makeup time of any
absences

Demonstrate knowledge of placement context

including organization’s philosophy, policies, practices,
and relationships with communities, groups, families,
and/or individuals involved with the organization
Seek and accept direction from staff and supervisors
when appropriate. Define this using your organization’s
policies and supervisor’s input.

Take initiative when appropriate. Define this using

your organization’s policies and supervisor’s input.

Complete assigned tasks in a timely manner

Supervisor’s evaluation at end of 200 hours: How well did the Community Worker-in-Training achieve
this goal?

Please circle one: Comments:

1. Exemplary community work
practice: a colleague more
than a student
2. Competent practice
3. Beginning to show competence
4. Not yet ready for practice
Field Placement Goal #5: To maintain effective working relationships.

Tasks to be completed to achieve this goal Community Worker-in-Training reflection on

professional learning
Build relationships with peers working at the
organization, including other placement students and
volunteer workers

Build relationships with staff at the organization

Build relationships with supervisor(s)

Demonstrate respect for diversity in culture and

experience of all co-workers

Participate appropriately in meetings with co-workers.

Define this using your organization’s practices and
supervisor’s input.

Supervisor’s evaluation at end of 200 hours: How well did the Community Worker-in-Training achieve
this goal?

Please circle one: Comments:

1. Exemplary community work
practice: a colleague more
than a student
2. Competent practice
3. Beginning to show competence
4. Not yet ready for practice
Field Placement Goal #6: To maintain professional helping relationships which adhere to professional, legal, and
ethical standards of practice and organizational requirements.

Tasks to be completed to achieve this goal Community Worker-in-Training reflection on

professional learning
Maintain confidentiality and legal rights of
families and individuals

Respect the right of communities, groups,

families, and individuals to self-determination

Demonstrate respect for diversity in culture

and experience of all participants in the
activities of the
organization
Assess the needs and resources of
communities, groups, families and/or
individuals as appropriate to
the placement context. Define this using your
organization’s
Advocate practices
and/or and supervisor’s
make referrals input.
in order to
assist communities, groups, families, and/or
individuals to
achieve their goals and needs as appropriate
to the placement context. Define this using

Supervisor’s evaluation at end of 200 hours: How well did the Community Worker-in-Training achieve
this goal?

Please circle one: Comments:

1. Exemplary community work
practice: a colleague more
than a student
2. Competent practice
3. Beginning to show competence
4. Not yet ready for practice
Supervisor’s Overall Evaluation on Completion of each 200 Placement Hours:

What are this Community Worker-in-Training’s specific areas of strength?

What are this Community Worker-in-Training’s specific areas for improvement in order to become a more effective
community worker?
 Supervisor’s comments on the overall experience of working with the Community Worker-in-Training:

How comfortable do you feel in recommending this Community Worker-in-Training for another placement or
employment in the field of community work?

Please circle one:

1. Strong recommendation for work in the field
2. Recommended for work in the field
3. Recommended for further field practice opportunities
4. Not yet ready for field practice

Comments:

Supervisor’s Signature on Completion of Evaluation:_

Student’s Signature on Completion of Evaluation:_