INTERNSHIP AGREEMENT (Form to be completed and returned to
the program instructor at the beginning of internship.)
(Form to be completed and returned to the program instructor at the beginning of internship.)
NAME OF STUDENT ______________________________________________
STUDENT E-MAIL ADDRESS ____________________________
PROGRAM TITLE _________________________________________________
EMPLOYER’S NAME, ADDRESS, AND PHONE NUMBER
The ________________________________________________________ agrees
Name of Organization
to provide an internship experience for the above student to work as a
IT IS FURTHER AGREED:
1. The internship will begin on __________________, 20 _____ and terminate on __________________, 20 _____.
2. The student will be employed as an intern for a minimum of ____________ hours a week.
3. The student will be given the opportunity to experience a wide variety of on-the-job experiences as part of the internship.
4. The student will prepare a final report outlining the benefits and drawbacks to the internship experience.
5. The college program instructor shall reserve the right to withdraw a student from the internship after consultation with the employer and the student.
6. All local, state, and federal laws will be observed.
7. Wages (if any) to be paid to the intern will be agreed upon by the employer and the student.
8. Safety instructions by the employer shall be an integral part of the internship experience.
9. The employer recognizes the importance of education for the student and will encourage the student to continue his or her education to completion of the certificate or degree.
student shall abide by the rules, regulations, and policies of the employing
Please describe, in the space below, what job responsibilities the intern will have and experience during the internship.
THE UNDERSIGNED HAVE READ, UNDERSTOOD, AND DO AGREE TO THE PROVISIONS OF THIS DOCUMENT.
Student _______________________________________________ Date __________
Employer _____________________________________________________ Date ____________
College Program Coordinator _______________________________ Date __________