NR621 Learning Agreement Template

Concluding Graduate Experience

Student Information:

• Name: [Your Full Name]
• Student ID (D#): [Your Student ID]
• Email: [Your Email Address]
• Phone Number: [Your Phone Number]

Mentor Information:

• Name and Credentials: [Mentor’s Full Name and Credentials]
• Contact Information:
  • Work Phone: [Mentor’s Work Phone Number]
  • Cell Phone: [Mentor’s Cell Phone Number]
  • Email: [Mentor’s Email Address]
  • Work Address: [Mentor’s Work Address]

Directions:

• Week 1: Initial Planning
  • Self-Identified Goals: In Week 1, identify your goals that align with the course outcomes. These goals should reflect what you aim to achieve during your practicum experience.
  • Initial Plans: Develop a strategy for how you plan to achieve these goals. Review your goals and plans with your mentor for feedback and make any necessary adjustments.
• Weekly Revisions:
  • Ongoing Updates: Revisit and revise the learning agreement weekly. Update completed goals, add new goals if needed, and adjust your plans based on actual experiences or feedback from your faculty or mentor.
• Week 6: Final Evaluation
  • Evaluation of Success: In Week 6, assess the success of your goals with your mentor. This evaluation should reflect on what you accomplished and any areas for improvement.
  • Mentor’s Signature: Obtain your mentor’s signature to confirm the completion and evaluation of your learning experience.
• Submission Details:
  • Initial Submission: Submit your completed Learning Agreement with your self-identified goals and plans by the end of Week 1.
  • Final Submission: Submit the revised and completed Learning Agreement with evaluations by the end of Week 6.
• Grading: Your Learning Agreement will be graded based on the Learning Agreement Grading Rubric. Feedback and grades will be provided after submissions in Week 1 and Week 6.

Sections of the Learning Agreement:

1. Goals and Plans:
   • Goal 1: [State your first goal]
     • Plan: [Describe how you will achieve this goal]
   • Goal 2: [State your second goal]
     • Plan: [Describe how you will achieve this goal]
   • (Continue for additional goals)
2. Weekly Updates:
   • Week 1: [Describe progress and any changes made]
   • Week 2: [Describe progress and any changes made]
   • (Continue for each subsequent week)
3. Final Evaluation:
   • Evaluation Summary: [Summarize the overall success in achieving your goals]
   • Mentor’s Feedback: [Include any feedback from your mentor]
   • Mentor’s Signature: ____________________________
   • Date: ____________________________