??ࡱ?>?? _a????^??????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????o ??Ebjbj??? 8Z??zf??zf?p???????YY??????????8?LA???"t%%%%%UUU+"-"-"-"-"-"-"$ $??&8Q"?933"99Q"YY%%f"???9RY%Y8%+"?9+"????%??????w??y??????^?"|"0?"?)??)?)??tU"w????UUUQ"Q"??UUU?"9999????????????????????????????????????????????????????????????????????)UUUUUUUUU : STATE OF CALIFORNIA DEPARTMENT OF EDUCATION REQUEST FOR UNPAID TRAINEE AUTHORIZATION FOR MINOR CDE Form B1-6 (Rev. 04-12) (Print Information) Minor?s InformationMinor?s Name (First and Last)Home PhoneBirth DateHome AddressCityZip Code Local Education Agency InformationLEA NameLEA PhoneLEA AddressCityZip CodeList educational program for this placement: To be filled in by employer or agency of placement.Business or Agency of Placement NameBusiness PhoneBusiness AddressCityZip CodeMinor?s services during unpaid training:Employer?s Name (Print First and Last)Employer?s SignatureDate To be signed by parent or legal guardian. As the parent or guardian, I hereby grant permission to the above minor to participate or be placed for unpaid training. I hereby certify that, to the best of my knowledge, the information herein is correct and true. Parent/Guardian?s Name (Print First and Last)Parent/Guardian?s SignatureDate Certification In compliance with California Education Code 51769, subject to certain exceptions, during the educational unpaid training placement, the LEA is responsible for providing worker?s compensation insurance covering that minor. I hereby certify that, to the best of my knowledge, the information herein is correct and true. Authorizing Personnel?s Name and Title (Print)Authorizing Personnel?s SignatureDate     Copy?Local Education Agency; Employer or Agency of Placement; Parent or Legal Guardian [ADVENTISTHEALTH:INTERNAL] +,Y^_chnrtuwxz{|}???????ƹ֭???????|l\L<\h(?h7[>6?CJOJQJaJh(?hV\66?CJOJQJaJh(?hYl6?CJOJQJaJh(?h(?5?CJOJQJaJh?\?5?CJOJQJaJh?w?CJOJQJaJhs?CJOJQJaJhaPCJOJQJaJh?v2CJOJQJaJh?v25?CJOJQJaJh(?h?v25?CJOJQJaJh(?h?v2CJOJQJaJh?W CJOJQJaJh(?h?v2CJOJQJaJ_z{|???????????Vykd$$If?l?????(?(???????????????? ? t?? ?????0???????(6?????????????????????4?4? la?lp? ????yt? $Ifgd(?gd?[?$a$gd?\?gd?v2  ??!0*gd?v2  ??!`'gd?v2????????????????????????????????³?????????td??U??U??FFh? h?\?CJOJQJaJh? h(?CJOJQJaJh? h'I?6?CJOJQJaJh? hW?6?CJOJQJaJh? h(?6?CJOJQJaJh? h?!6?CJOJQJaJh? h?!CJOJQJaJh? h?TwCJOJQJaJh? h?!5?CJOJQJaJh? h?q?5?CJOJQJaJh(?h?[?6?CJOJQJaJh?\?6?CJOJQJaJ????????????:?kd?$$If?l?P??r? !(?$ ? t??(6?????????????????????????4?4? la?lp?2??????????yt? $Ifgd? $Ifgd\h $Ifgd?\??????????????KB $Ifgd?\??kd?$$If?l?r? !(?$ ? t??(6?????????????????????????4?4? la?lp?2??????????yt? $$Ifa$gd? ????????????kdi$$If?l????r? !(?$ ? t??(6?????????????????????????4?4? la?lp?2??????????yt? ??$If]??gd? $Ifgd?\????????????     + , - . / 0 9 : D E F G H I J K W X ] ^ g h ? ? ? ? ? ????????????????????????????????????{kh? h(?5?CJOJQJaJh(?h?v2CJOJQJaJh? h?v2CJOJQJaJh? h?ttCJOJQJaJh? h?tt5?CJOJQJaJh??CJOJQJaJh? h?iCJOJQJaJh? hYlCJOJQJaJh? h(?CJOJQJaJh? h?\?CJOJQJaJ*?????  ?????;?kdQ$$If?l?r? !(?$ ? t??(6?????????????????????????4?4? la?lp?2??????????yt? $??$If]??a$gd? $$Ifa$gd?   + , - . / ??z???ykd/$$If?l?????(?(???????????????? ? t?? ?????0???????(6?????????????????????4?4? la?lp? ????yt? $Ifgd8k?/ 0 9 : D ?wnw $Ifgd8k? $$Ifa$gd? |kd?$$If?l?P??F?X ?\  t??(6???? ???? ???? ???? ???4?4? la?lp???????yt? D E F G H I J ?||||| $Ifgd8k?zkd?$$If?l?F?X ?\  t??(6???? ???? ???? ???? ???4?4? la?lp???????yt? J K W X ] ^ g UIIIII $$Ifa$gd? ?kd&$$If?l????r?X ?!(?\ hT t??(6?????????????????????????4?4? la?lp?2??????????yt? g h ? ? WQQ$If?kd$$If?l?r?X ?!(?\ hT t??(6?????????????????????????4?4? la?lp?2??????????yt? ? ? ? ? ??? $Ifgd(?akd?$$If?l?P??0x(x? t??(6?????????????4?4? la?lp?????yt? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?        $ % . / 7 @ ??Ͽ??????????????tttttt?tttttteVh? h?!CJOJQJaJh? hC?CJOJQJaJh? h?iCJOJQJaJh? h(?CJOJQJaJh? h??CJOJQJaJh? hA ?CJOJQJaJh? h?TwCJOJQJaJh? h??5?CJOJQJaJh? hN?5?CJOJQJaJh? h9?5?CJOJQJaJh? h?U?5?CJOJQJaJ!? ? ? ? ? ?|p| $$Ifa$gd? $Ifgd?\?ykdp$$If?l?????(?(???????????????? ? t?? ?????0???????(6?????????????????????4?4? la?lp? ????yt? ? ? ? ?  ?wkw $$Ifa$gd? $$Ifa$gd? |kd! $$If?l?4?F? ?$  t??(6???? ???? ???? ???? ???4?4? la?lp???????yt?    ?zzzzz $Ifgd?\?|kd? $$If?l?3?F? ?$  t??(6???? ???? ???? ???? ???4?4? la?lp???????yt?    $ % . UIIIII $$Ifa$gd? ?kdk $$If?l????r? !(?$ ? t??(6?????????????????????????4?4? la?lp?2??????????yt? . / X Y WNN $Ifgd?\??kdS $$If?l?r? !(?$ ? t??(6?????????????????????????4?4? la?lp?2??????????yt? @ A W X Y Z [ \ ] ^ _ ` a b c d t ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ???????????????Ĵ?????ĥ???u??eUUh? hA ?5?CJOJQJaJh? hN?5?CJOJQJaJh? h?nJ5?CJOJQJaJh? h(?5?CJOJQJaJh? h?U?5?CJOJQJaJh(?hA ?CJOJQJaJh? h?v26?CJOJQJaJh? h?v2CJOJQJaJh? h?iCJOJQJaJh? h?!CJOJQJaJh? hn%?CJOJQJaJ!Y Z [ \ ] ??J?Ikd? $$If?l????(( t??(6?????????4?4? la?lp? ??yt? $Ifgd?\?akd1 $$If?l?P??0?(?4 t??(6?????????????4?4? la?lp?????yt? ] ^ _ ` a b c ?????? $Ifgd?\?Ikd! $$If?l????(( t??(6?????????4?4? la?lp? ??yt? c d ? ? ."" $$Ifa$gd? ?kd? $$If?l????r? (?????????? ???? t??0???????(6??????????????????????????????????4?4? la?lp?2??????????yt? ? ? ? ? ??? $$Ifa$gd? ? ? ? ? .,# $Ifgd(??kd?$$If?l?????r? (?????????????? ???????? t??0???????(6????????????????????????????????????????4?4? la?lp?2??????????yt? ? ? ? N ? ? ? ? ? ? ????????? $Ifgd??^ $Ifgd6=??x?xgd?Rcgd;?Ykd?$$If?l? ??(?( ? t?? ?????(6?????????4?4? l`? ????a?lp? ????yt? ? ? ?  + M N ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?????ҸҸ?????????|l]M=h? hv$6?CJOJQJaJh? h?W?6?CJOJQJaJh? h?=mCJOJQJaJh? h?=m6?CJOJQJaJh? hv$CJOJQJaJh? hV\6CJOJQJaJh? hp?CJOJQJaJh? h8u?CJOJQJaJh?i6?CJOJQJaJhX%?6?CJOJQJaJh(?h?i6?CJOJQJaJh(?h??6?CJOJQJaJh;?6?CJOJQJaJ? ? ? ? ?  UI@I7I $Ifgd??^ $Ifgd6=? $$Ifa$gd? ?kdr$$If?l???r??`?(??? ?% t??(6?????????????????????????4?4? la?lp?2??????????yt? ? ? ? ? ? ? ? ? ? ?       5 I ? ? V ??Ͽ??????????uh[L[[<<h(?h@I?6?CJOJQJaJh?G;h?G;CJOJQJaJh?G;6?CJOJQJaJh)7V6?CJOJQJaJh? h)7V6?CJOJQJaJh? h)7V5?CJOJQJaJh(?CJOJQJaJh? hV\6CJOJQJaJh? h8u?CJOJQJaJh? hp?6?CJOJQJaJh? hv$6?CJOJQJaJh? h?!6?CJOJQJaJh? h(?6?CJOJQJaJ    WRF $$Ifa$gd? gdgy?kdZ$$If?l?r??`?(??? ?% t??(6?????????????????????????4?4? la?lp?2??????????yt?    ? ? W X Y Z [ \ ?????????? $IfgdKI?xgd?Rcgd??^Ykd8$$If?l????(?( ? t?? ?????(6?????????4?4? l`? ????a?lp? ????yt? V W X Y Z [ \ ] ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? !"#???????????????㵭???????????????????tt?t?p?h??h??CJOJQJaJh?[?h??CJOJQJaJ*jh?QCJOJQJUaJmHnHuh?Qh?]*jh?]*Uh(?h?iCJOJQJaJh? h?=m6?CJOJQJaJh? h?=mCJOJQJaJh? h??CJOJQJaJh@I?6?CJOJQJaJ,\ ] ? ? ? ? ? UI@I@I $IfgdKI $$Ifa$gd? ?kd?$$If?l????r??~?(??? ^8 t??(6?????????????????????????4?4? la?lp?2??????????yt? ? ? ? ? ? ? ? ? ? ? WRPPPPPPPgd?i?kd?$$If?l?r??~?(??? ^8 t??(6?????????????????????????4?4? la?lp?2??????????yt? ? ? ? ? ? ? ? ? !"#$%&'BCDE??????????????????gd?igd?Q#$%&'ABCDE?????????h(?h?iCJOJQJaJ%h?Qh?QB*CJOJQJ^Jphh?Qh?]* 61?h/R :p?v2??/ ??=!?8"?8#??$??%????? ???$$If?l!vh#v(:V ?l??? ? t?? ?????0???????(6,?5?(/? ????????a?lp? ????yt? ?$$If?l!vh#v#v?#v$ #v?#v:V ?l?P? t??(6,?5?5??5?$ 5??5?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v#v?#v$ #v?#v:V ?l t??(65?5??5?$ 5??5?/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v#v?#v$ #v?#v:V ?l??? t??(6,?5?5??5?$ 5??5?/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v#v?#v$ #v?#v:V ?l t??(65?5??5?$ 5??5?/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v(:V ?l??? ? t?? ?????0???????(6,?5?(/? ????????a?lp? ????yt? ?$$If?l!vh#v#v?#v\ :V ?l?P? t??(6??,?5?5??5?\ /? ?a?lp???????yt? ?$$If?l!vh#v#v?#v\ :V ?l t??(6??5?5??5?\ /? ?/? ?a?lp???????yt? ?$$If?l!vh#v#v?#v\ #vh#vT:V ?l??? t??(6,?5?5??5?\ 5?h5?T/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v#v?#v\ #vh#vT:V ?l t??(65?5??5?\ 5?h5?T/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#vx#v?:V ?l?P? t??(6,?5?x5??/? ?a?lp?????yt? ?$$If?l!vh#v(:V ?l??? ? t?? ?????0???????(6,?5?(/? ????????a?lp? ????yt? ?$$If?l!vh#v#v?#v$ :V ?l?4 t??(6??,?5?5??5?$ /? ?/? ?a?lp???????yt? ?$$If?l!vh#v#v?#v$ :V ?l?3 t??(6??5?5??5?$ /? ?a?lp???????yt? ?$$If?l!vh#v#v?#v$ #v?#v:V ?l??? t??(6,?5?5??5?$ 5??5?/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v#v?#v$ #v?#v:V ?l t??(65?5??5?$ 5??5?/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v?#v4:V ?l?P? t??(6,?5??5?4/? ?a?lp?????yt? j$$If?l!vh#v(:V ?l??? t??(6,?5?(/? ?a?lp? ??yt? j$$If?l!vh#v(:V ?l??? t??(6,?5?(/? ?a?lp? ??yt? C$$If?l!vh#v#v?#v?#v #v:V ?l?? t??0???????(6,?5?5??5??5? 5?/? ????????/? ?/? ????????/? ?/? ????????/? ?a?lp?2??????????yt? !$$If?l!vh#v#v?#v?#v #v:V ?l??? t??0???????(65?5??5??5? 5?/? ?/? ?/? ?/? ????????a?lp?2??????????yt? {$$If?l!vh#v(:V ?l? ? ? t?? ?????(6,?5?(`? ????a?lp? ????yt? ?$$If?l!vh#v?#v?#v? #v?#v%:V ?l?? t??(6,?5??5??5?? 5??5?%/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v?#v?#v? #v?#v%:V ?l t??(65??5??5?? 5??5?%/? ?/? ?/? ?a?lp?2??????????yt? {$$If?l!vh#v(:V ?l??? ? t?? ?????(6,?5?(`? ????a?lp? ????yt? ?$$If?l!vh#v?#v?#v? #v^#v8:V ?l??? t??(6,?5??5??5?? 5?^5?8/? ?/? ?/? ?a?lp?2??????????yt? ?$$If?l!vh#v?#v?#v? #v^#v8:V ?l t??(65??5??5?? 5?^5?8/? ?/? ?/? ?a?lp?2??????????yt? y2???? 0@P`p??????2(?? 0@P`p?????? 0@P`p?????? 0@P`p?????? 0@P`p?????? 0@P`p?????? 0@P`p??8X?V~???????? 0@?? 0@?? 0@?? 0@?? 0@?? 0@?? 0@?? 0@?? 0@?? 0@?? 0@?? 0@?? 0@?? 0@666666_HmH nH sH tH H`??H Normal CJOJQJ_HaJmH sH tH DA ???D Default Paragraph FontRi@???R  Table Normal?4? l4?a? (k ???(No List 4@?4 ?\?Header  ???!4 @4 ?\?Footer  ???!j??j ?\? Table Grid7:V?0??????PK!????[Content_Types].xml???N?0E?H???-J??@%?ǎǢ|?ș$?ز?U??L?TB? l,?3??;?r??Ø??J??B+$?G]??7O٭V?? G???R???U1?a$?N?%? ??ʣꂣKЛ?j?VkUDR?KQj/?d???R???*SxM?PsʧJ5?$4vq^W?Cʽ D{>̳`?3?R?EB?=????꽻Ut? Qy@֐??\.X?7??<:+& ?0h? ?@?>n??ƭB???V?q?u?? ???ѡ{?5??????????kP????O&C???נ ???Aw0??kP?o??۵?(h[?5(?$=?C??Vs?]mY2z?w?`?n??KDC]j?%K?XK? ?'P@?$I=?Y?%?C%g?x'$?!?V(e?k?ڤք???'?Qt??!?x?7??xb??J????7 o????߼???W_?y??|n?ʒ;Fid???????o????/_?1?z/L?????????>????o??????????_;??9:3?3?`?=—?S???????,FĔ觑@)R?8?el?mE??v|?!ո???/,?Ә?%qh|'?1:`?i??j.?̳u?'?k?? ??C?Z^?W?c?K?0??'?E8??S߱s????ˮ?dΙ`K?}A?"N??șM??1I?/A?e???ހQתG??F??@?A~??e??h-Q?R9C 5 ~?d?"9?? ??0e?x??p? N??Vl%?kv:????Ns??? _?O???u?C??X?=?mO????4???m's?߸?d|?0n;??p??t2e?}?:??z??Or??gI(?? ?'B??=??????'??8\???L`?"???Ǚ? ??4F+8??JI$rՑ?VL???v?Vx?NN?";????fVY??x-,??Jf?V? h?P??!aLf?h:H????H?X?? ?W?QXt,:J??U{,?Z???????? Bp??B?)s?ֻڙ?Ӈ?iE4??(=?U\.O?. ?+x?"a??MB[F7x"???yt?ѫи????K-z?z>??F??>7?5?????????e?o5C?9Z??%?c????7?ܼ?%?6?M2ˊ 9B"? ??N? "1?(Iz?Z~???????>Yr]H+?9p??d?\?4?n?(Kg???\??V???$??=???]?B,lוD??A=???eX?????)Ly?5o?t e㈮b?W3?gp?? :????? j?$/?g?*??Q?jZT??????a!e9#i?5??*?j???5ö ???fE?`?51?4??g?{7?v??n?O(??????^? ???,j??~V9;?k?v??v?"ad??V?݊?oT?An7jah??+?????y???^@?A???RhW??.G?MuO?? ?"/e?5??[s??`???Z'W?fP?t?~???f}?k?A?'?0????????z|??>???ܙ?????|U?w????{?@???՘t??A??m?'?`4?T??֠2j ۣ?hv??W?w??A?9 Z?N?U+A???w??v?h?v?3???6V????`^?????PK! ѐ??'theme/theme/_rels/themeManager.xml.rels??M ?0???wooӺ?&݈Э???5 6?$Q?? ?,.?a??i????c2?1h?:?q??m??@RN??;d?`??o7?g?K(M&$R(.1?r'J??ЊT???8??V?"??AȻ?H?u}??|?$?b{??P????8?g/]?QAsم(????#??L?[??????PK-!????[Content_Types].xmlPK-!?֧??6 0_rels/.relsPK-!ky???theme/theme/themeManager.xmlPK-!??g??? ?theme/theme/theme1.xmlPK-! ѐ??'? theme/theme/_rels/themeManager.xml.relsPK]? E??????????????E%Z???? kmor??? @ ? ? V #E #%(,???? / D J g ? ? ?  . Y ] c ? ? ? ?   \ ? ? E  !"$&')*+?@? @?????????" ?? ?( ? ???? ? ? ?v??0?????????>???MSIPCM4eb54f4ba42df8a7793255bf{"HashCode":-1902053478,"Height":792.0,"Width":612.0,"Placement":"Footer","Index":"Primary","Section":1,"Top":0.0,"Left":0.0}C"??`?????? ????0?( ? ??B ?S ???? ??r;?/?<k??,p? -p? **F44F9*?urn:schemas-microsoft-com:office:smarttags?State?9*?urn:schemas-microsoft-com:office:smarttags?place? R??????????"&F??????????"&'CF{||?????????????????????????????? GG^^_???????+MN???????????????????V??????&F88hltuwxGG+?????????????"&'CF???K{??Kbj?B?-? ? ?6 ?W ? ? *0 O KI?i~gy?LLd?LYl? ,P ?!v$.$"$?W(-j)q**?]*@M.?{1?v2V\6v:?G;jE<?k<?=?Q=7[>???wA?~CmEmkF?nJZ[K?uMaP?Q?2QScR|`Sk\U)7V?W9 X@X?Z?uZ?2[??^?Rc?Mdnekg?@h\h?=m?anSpvtA#t[7t?tt?TwsJy~bzHxz?w|%r?N ?p?9?sM?!m?W??J?g^?(???@I??\??W????O?s?X%?+1?WJ?@x??M????*?n%??Y?,U????f????/?N?;??|??R?6=?g??g?~{????a??o????6?M??q?8u?8k??w?a4?????:?.H??~?A ????[????U?'I?~?C??6?? D???to????@?E(@??Unknown????????????G??.?[x? ?Times New Roman5??Symbol3.? ?.?[x? ?Arial7.??.?{$? ?CalibriC.,?.?{$? ?Calibri LightA????$B?Cambria Math"1???h?ⴧ?ⴧNc??? ?? !?8?????4??2?Q???HP ??????????????????????????K2!xx????8 ???JUnpaid Trainee Authorization Form - Work Experience (CA Dept of Education)?The REQUEST FOR VOLUNTEER/UNPAID TRAINEE AUTHORIZATION FOR MINOR form must be completed and submitted to the local education agency of minor's enrollment. volunteer Davis,MariaAlvarez,Valeria?? ?????Oh??+'??0p???????? ?  , 8 DPX`h?LUnpaid Trainee Authorization Form - Work Experience (CA Dept of Education)?The REQUEST FOR VOLUNTEER/UNPAID TRAINEE AUTHORIZATION FOR MINOR form must be completed and submitted to the local education agency of minor's enrollment. Davis,Maria volunteerNormalAlvarez,Valeria2Microsoft Office Word@F?#@ܑK(??@???y?@???y????? ??՜.??+,??D??՜.??+,???L hp???? ???? ? +?Calif. Dept. of Education ? KUnpaid Trainee Authorization Form - Work Experience (CA Dept of Education) Title? P,L`???8MSIP_Label_f52c3125-80bb-477a-b344-92315e736908_Enabled8MSIP_Label_f52c3125-80bb-477a-b344-92315e736908_SetDate7MSIP_Label_f52c3125-80bb-477a-b344-92315e736908_Method5MSIP_Label_f52c3125-80bb-477a-b344-92315e736908_Name7MSIP_Label_f52c3125-80bb-477a-b344-92315e736908_SiteId9MSIP_Label_f52c3125-80bb-477a-b344-92315e736908_ActionId<MSIP_Label_f52c3125-80bb-477a-b344-92315e736908_ContentBits?true2023-04-28T17:26:00Z Standard(f52c3125-80bb-477a-b344-92315e736908(d931cb4a-3984-4328-9fb6-96d7d7fd51b0(e765b08f-bc5d-4c1c-9788-c2cd8bf8188d2  !"#$%&'()*+,-????/012345678????:;<=>?@ABCDEFGHIJKLM????OPQRSTU????WXYZ[\]????????`????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????Root Entry???????? ?FAx??y?b?Data ????????????.{1Table????9)WordDocument????8ZSummaryInformation(????????????NDocumentSummaryInformation8????????VCompObj????????????r?????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????? ???? ?F Microsoft Word 97-2003 Document MSWordDocWord.Document.8?9?q
Baidu