Center for Educational Programs

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Center for Educational Programs

GWINNETT COUNTY PUBLIC SCHOOLS GIFTED PROGRAM

STUDENT/PARENT PREREGISTRATION PROCEDURE, APPLICATION, AND AGREEMENT FOR THE QUEST STUDENT INTERNSHIP

THE PURPOSE OF THIS PROCEDURE IS TO THOROUGHLY INFORM BOTH STUDENTS AND PARENTS ABOUT THE QUEST STUDENT INTERN PROGRAM AND TO AID IN THE FINDING OF THE BEST PLACEMENTS FOR STUDENTS. THE INFORMATION GIVEN IN THIS DOCUMENT IS IMPORTANT BECAUSE IT EXPLAINS MANY OF THE DETAILS OF THE INTERNSHIP PROGRAM.

INSTRUCTIONS:

Please read the attached pamphlet: “The QUEST Student Intern Program: An Opportunity for you to Explore a Career.” Then complete the information card. Finally, answer the questions below and sign the last page. Keep the bottom pink copies of this document for later reference.

Acceptance into the program is contingent on the school’s recommendation and the appropriateness of the internship placement and the prospective mentor. Students will be expected to talk with the supervising teacher prior to the placement search in order to ascertain what is best for the student’s program of study. The student’s application must be submitted by the deadline date. There is a limit on the number of registrations that will be accepted.

BOTH THE INFORMATION CARD AND THE TOP TWO COPIES OF THIS DOCUMENT MUST BE GIVEN TO YOUR GIFTED PROGRAM CONTACT TEACHER BY ______.

NAME OF STUDENT APPLYING: ______

SCHOOL: ______APPLICATION FOR FALL / SPRING SEMESTER 20______

GRADE IN WHICH YOU WILL BE THE SEMESTER FOR WHICH YOU ARE REGISTERING ______

NUMBER OF CREDIT HOURS YOU WISH TO EARN? (CIRCLE ONE) 510

IF YOU ARE CONTINUING A PREVIOUS INTERNSHIP, CHECK HERE ______AND YOU MAY SKIP QUESTIONS #1 AND #5.

The student MUST have his/her own transportation. We try to place students close to the school or at least within a 30 minute drive but that may not be possible.

How far away are you willing for the student to drive?

(a) only in the immediate school district ______

(b) only in Gwinnett County ______

______

(d) are there other transportation concerns______

______

At the beginning of the semester, parents and students MUST sign an insurance information release form which relieves the school system and the employer of insurance liability and states that the student has both health and car insurance.

Should transportation become a problem, notify the intern supervising teacher immediately.

In what extracurricular activities is the student involved?

______

If the student is involved in extracurricular activities or sports or has a job, he/she must make arrangements to miss those activities two afternoons a week. This is necessary because most mentors work with their interns for 2 ½ to 3 hours, two days a week (Monday-Friday). In addition, inters will be meeting for seminars about four times during the semester. These are also held in the afternoon and seminar attendance is one of the requirements for the class. Do you as parent(s) and student understand the necessity of being committed to such arrangements prior to registration? ______

If you already know which two days of the week you would prefer to work, please list here. ______

For some placements (e.g. medical, veterinary, laboratory, dentistry, etc.) special immunizations or health certifications are necessary for acceptance. Are you willing to get these, including bearing the cost? _____

You should be aware that some placements require a criminal background check and drug testing before the mentor site will accept an intern.

On the information card the student is asked to list four preference areas of placement. Please describe the following about each: (a) why you are interested in this area and think you might want to explore that career; (b) what you have already done in an attempt to explore aspects of that career area (activities, classes, research projects, part time jobs, etc.).

Area 1: ______

______

Area 2: ______

______

Area 3: ______

______

Area 4: ______

______

Students are asked to behave in a mature fashion since they will be out among adults in the “real” world. Behavior such as promptness, appropriateness of dress, planning ahead, courtesy and responsibility are expected as a matter of course. Students are considered as employees by their mentors and as such are to abide by the same rules and regulations expected of employees.

Student: Are you prepared to assume such responsibility and do you understand that a large part of your grade rests upon this behavior?

______

(yes / no)(Student’s initials)

This is a class and as such has assignments and activities which you must complete in order to get the class credit. You receive a numerical grade for your work. Part of your responsibility is submitting assignments when they are due.

Student: Are you willing to abide by the rules and regulations of the QUEST Internship Program?

______

(yes / no)(Student’s initials)

The signatures below certify that we have read the accompanying pamphlet and completed the document above and that we understand that the QUEST Student Intern Program has unique requirements and expectations of students. We agree to abide by these requirements and expectations.

______

(Signature of Student) (Signature of Parent)

______

Date

PLEASE KEEP THE BOTTOM (PINK) COPIES OF THIS DOCUMENT FOR FUTHER REFERENCE.

4/02

White – Intern Supervising Teacher Yellow – Gifted Program Teacher Pink - Parent