COOPERATIVE EDUCATION AND INTERNSHIP PROGRAM
Enrollment Form
Career Services ● Cooperative Education & Internship Program ● (575) 646-4115 ● Fax: (575) 646-5421 ● ● careerservices.nmsu.edu
Revised 12/1/2014
Name: Current Date:
Aggie ID: Major:
Phone Number: ( __ ) Minor/Concentration:
NMSU Email: Expected Graduation Date (MM/YY): ______
Citizenship: U.S. Citizen F-1/J-1 Student Visa Permanent U.S. Resident Other: ______
Company/Employer: Supervisor: ______
Address: Supervisor Title/Position: ______
Supervisor Work Phone: (______) ______
______Supervisor Fax: (______) ______
City: ______State: Zip: Supervisor Email:
Co-op/Internship Term (Please Select One): Spring Summer Fall Position Title: ______
Assignment Type:
NMSU Student Co-op Employment - Part-Time (min. of 15 and a max of 20 hours per week during the spring and fall academic semester)
During the summer semester, fall break, winter break and spring break, the students may work a maximum of (40) hours per week.
Part-Time (Outside of NMSU) (Parallel – 15 – 29 Hours)
Full-Time (Students employed in the status of Co-op or Internship must satisfy both the requirements for the Cooperative Education &
Internship Program and employment policies and procedures related to the university or outside organization.)
Assignment Duration: Start Date: ______|______|______End Date: ______½______½______
MM DD YY MM DD YY
Wage/Salary: $ ______ Hourly Monthly Stipend Semester
Is this a continuation of a previous work assignment? Yes No
I certify that the information entered in sections 2 and 3 are correct and accurate.
I agree to inform the NMSU Cooperative Education and Internship Program in a prompt manner about any changes to the student’s work assignment status, job duties, work hours or any information that would alter the details listed in sections 2 and 3. I also agree to complete a performance evaluation of the student’s work and provide the student and NMSU’s Cooperative Education and Internship office with a copy.
Name (Printed) Signature Date
1. Cooperative Education/Internship students must update their Cooperative Education/Internship file at the beginning of every semester (including summer) in order to verify full-time workphase, part-time workphase or school phase status. Work assignments will not be authenticated until all required paperwork for the semester is completed.
2. Full-time student status remains intact for the duration of an approved workphase, and the student is entitled to many of the privileges which accrue to full-time students at NMSU’s Las Cruces Campus.
3. The student will work to the best of his/her ability to meet the expectations of the Cooperative Education or Internship employer.
4. The student will abide by all policies, rules and regulations prescribed by the Cooperative Education or Internship employer.
5. The student will abide by all policies, rules and regulations prescribed by New Mexico State University, including the Code of Professional and Ethical Conduct and Learning Agreement.
6. Although the Program will confirm workphase status with the student’s college and other NMSU departments/offices with whom the student is contractually engaged or obliged (e.g. Registrar, Housing, Financial Aid), the primary responsibility for reporting the Cooperative Education/Internship work assignment and maintaining communication with these entities will belong to the student.
7. The student will complete and return the Work Assignment Evaluation sent by the Program via e-mail.
8. The student may enroll for a maximum of six (6) credits at an institution of higher education while on full-time workphase, as long as the academic responsibilities do not interfere in any way with his/her work obligations to the employer.
9. Part-time (parallel) students must maintain full-time student status.
10. The student will register for classes to be taken upon return to campus as prescribed by the NMSU Registrar’s instructions.
1. The Program will work on the student’s behalf while the student is enrolled in the workphase.
2. The Program will be available to assist (where possible) in the resolution of any Cooperative Education or Internship related problems which may arise during the workphase.
3. The Program will ensure that the Cooperative Education/Internship workphase is reflected in the student’s academic transcript, provided the student has registered his/her semester Cooperative Education/Internship work assignment, as required and has no academic holds.
4. The Program will provide the college, the employer, and/or the student with any information pertaining to the student’s status with the Program, the employer, or the University, as is needed for effective administration of the Cooperative Education/Internship experience. (This includes unofficial transcripts.)
5. The Program will provide a Work Assignment Evaluation to allow the student to evaluate the Cooperative Education/Internship experience and an Evaluation Form so that the employer can assess the performance of the student.
I certify that the information submitted for my current work assignment is accurate and correct.
I agree to inform the NMSU Cooperative Education and Internship Program in a prompt manner about any changes to my work assignment status, job duties, work hours or any information that would alter the details listed above, including letter of resignation, requests for leave of absence, etc.
I have read, understand and accept all conditions, rights and responsibilities associated with the Cooperative Education/Internship Program listed in section 5 of this form.
______
Signature Date
I certify that the student listed above meets all requirements to participate in the NMSU Cooperative Education and Internship Program.
I certify that the work assignment information entered above meets the requirements of the NMSU Cooperative Education and Internship Program.
______
Signature Date
Earned Hours: Classification: FR SO JR SR Masters Doctorate
Cum GPA: Major/Job Match: Yes No
Current Term/Credits: Pathways Agreement Received (if required): ______(MM/DD/YY)
Offer Letter Received: __ (MM/DD/YY) Advisor Approval (if required): ______(MM/DD/YY)
Job Description Received: ______(MM/DD/YY) Banner Code (SGACOOP): P W
AggieCAREER Manager Job ID: ______Co-op Module: _ ___ (MM/DD/YY) Staff: ______
Course Registration (SFAREGS): ______(MM/DD/YY) Sent to International Student Services (if required): _____ (MM/DD/YY)
CRN: No. of Credits:
Comments:
______
Career Services ● Cooperative Education & Internship Program ● (575) 646-4115 ● Fax: (575) 646-5421 ● ● careerservices.nmsu.edu
Revised 12/1/2014