Eastern Washington University 7/7/2025

SOCIAL WORK STUDENT AFFILIATION & PRACTICUM PLACEMENT AGREEMENT This Agreement is made and entered into by and between Eastern Washington University (“EWU”), located at 526 5th St, Cheney, WA 99004 and (“Agency”), located at _________________________________________________________(individually and collectively, “Agency”). The purpose of this Agreement is to cooperate in providing practicum placement educational experiences (“Program”) for Social Work students of EWU. In consideration of the mutual benefits of such a Program, the parties to this Agreement agree that the Program shall be covered by and subject to the following conditions: A. MUTUAL RIGHTS AND RESPONSIBILITIES 1. The parties agree to cooperate in jointly planning the Program through EWU at the Agency and in jointly evaluating EWU students. 2. The parties agree to comply with all applicable state and federal laws, rules, regulations, and executive orders governing equal employment opportunity, immigration and nondiscrimination, including the Americans with Disabilities Act. Neither party will discriminate, to the extent required by state and federal law, on the basis of race, religion, color, national origin, marital status, sex, sexual orientation, gender identity, age, genetic information, pregnancy, honorably discharged veteran or military status, or the presence of any sensory, mental or physical disability. 3. Visits by EWU staff to the Agency for the purposes of planning and evaluating the Program, discussing student performance, learning new skills, and arranging for additional educational experiences will be welcomed. 4. EWU and Agency will instruct their respective faculty, staff, and students participating in the Program, to maintain confidentiality of student and patient information as required by law, including, but not limited to the Family Educational Rights and Privacy Act (FERPA), the Health Insurance Portability and Accountability Act (HIPAA) and by the respective policies and procedures of EWU and Agency. i. If EWU is sharing student education records, as defined by FERPA, with the Facility beyond a student’s name, enrolment status, and contact information, Facility agrees to the following: 1) Facility must keep the student education records confidential and not disclose, transfer, or sell such information unless such disclosure is required by law. 2) Facility must establish and implement minimum physical, electronic, and managerial safeguards for maintaining the confidentiality of the information provided by EWU. Facility must exercise due care and take commercially best efforts to protect the security of EWU’s confidential information. Access to the information must be restricted to only those authorized staff, officials, and agents of the Facility who need it to perform their official duties. 3) If Facility or its agents detect a compromise or potential compromise in the security of the student education records such that the information may have been accessed or disclosed without proper authorization, Facility must notify EWU of such incident no later than 48 hours after it is detected. Facility must then take corrective action as soon as practicable to eliminate the cause of the breach. Facility must cooperate with EWU in providing any notices required by applicable state or federal law. 4) Confidential information will be provided via email or a secured file transfer mechanism between the parties. The Facility will not have access to any EWU systems. ii. Examples of confidential student education records include, but are not limited to, student identification numbers, date of birth, social security numbers, criminal background checks, immunization records, or grade information. City Of Everett 2930 Wetmore Ave Everett, WA 98201