Student/Agency Agreement Form
I, ____________________________, have selected ______________________________
(Print Student’s Name)
(Employment Agency Name)
as my Employment Agency (Agency) for the School-to-Work program (S2W) and we will begin
working together on this date: __________________________.
By choosing this agency, and signing this form, I am requesting that King County Developmental
Disabilities Division (KCDDD) pay this Agency for supported employment services through S2W,
effective on the date written above.
My S2W team consists of my:
Teacher, ___________________________, at _______________________ School District
Employment Consultant (if determined), ________________________
Developmental Disabilities Case Manager (if applicable), _____________________________
I understand the following about what it means to participate in S2W:
The Agency will work with my S2W team to