DEPARTMENT OF KINESIOLOGY & RECREATION
HEALTH FITNESS INTERNSHIP
CONTACT INFORMATION
Students: Print out 2 copies of this form, complete the information, & sign the contract after discussion with your potential supervisor. Give one copy to your supervisor at your chosen site. Return one to your instructor at FSU by November 30th, 2017.
Student Name: ______GPA: ______
Phone number: ______Class standing: ______
E-mail address: ______
When I graduate from FSU, I want to: ______
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Previous FE placements: ______
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Site Name: ______
Address: ______
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Phone Number: ______Ext: ______
Supervisor’s Name: ______
E-mail: ______
Phone Number: ______
Description of the Facility: ______
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Your role at that facility as a student: ______
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Student Signature: ______
Supervisor Signature: ______
Date: ______
Name______Birth Date______
Mailing address ______
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Permanent Address ______
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Telephone ______
Major: ______
Expected Graduation Date______
Grade Point Average (major)______Grade Point Average (overall)______
Total Semester Hours Completed______
Car: ( ) yes ( ) no
What professional clubs or organizations are you currently a member of?
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What offices have you held and what honors have you received in high school and college?
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What job experiences relate to your internship placement?
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What would you like to accomplish during your internship? List goals and objectives.
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List your strengths and weaknesses as you presently perceive them related to completing an internship.
STRENGTHS:______
WEAKNESSES:______
Give a brief biographical sketch. Include what influenced and motivated you to pursue this career path. Explain what contributions you can make to the Health/Fitness field. Why did you choose the Health/Fitness concentration?
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Define professionalism and teamwork. How does this relate to your philosophy of Health/Fitness?
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List three different topic areas for a special project.
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Attach a copy of your professional resume and your course audit to this application form detailing all courses and grades received for those courses throughout your college career. This course audit can be obtained from your advisor, the registrar, or on Paws.
Questions/ Requirements for potential Internship Sites
Is the facility a certified fitness/ wellness center?
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What degree does my potential supervisor have?
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Does my supervisor/ anyone I will be working with have any specific certifications? (CSCS, NSCA, SCCC, AFPA, etc.)
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What is your favorite part of working here?
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What would my daily tasks and duties consist of?
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Who will I work with most closely?
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Are there enough clientele for me to be able to complete my tests needed (minimum of 100).
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Can I complete 405 hours during the semester (30-35 hours/week) at this facility?
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DEPARTMENT OF KINESIOLOGY & RECREATION
HEALTH FITNESS INTERNSHIP
COOPERATING SITE AGREEMENT & CONTRACT
The purpose of the internship is to provide a means for applying theoretical concepts learned in the undergraduate Exercise & Sport Science Curriculum to a practical situation. This experience is an opportunity for the student to learn to effectively deliver health and fitness concepts to target populations. During this experience the student will have the opportunity to experience and enhance their knowledge of health & fitness, but also to learn about the business aspect of health & fitness management. The supervising internship site plays a vital role in the professional preparation of the intern. Frequently, the internship site is the student’s first exposure to the professional world. In order to ensure a quality experience for both the student-intern and for the supervising internship site expectations and responsibilities will be outlined for all participating persons.
STUDENT INTERN RESPONSIBILITIES
During their professional placement in an internship facility, the student intern will be responsible for fulfilling the following requirements:
(1) The intern must complete a minimum of 45 hours on the job for each credit that they are registered for. This will equal 405 total hours, or approximately 30 hours per week during a typical semester. All hours must be logged and then verified by the direct supervisor.
(2) The intern must keep a daily log of all activities that will be handed into the program coordinator following the internship. This log should include specific assignments and activities carried out each day of the internship.
(3) The intern must fulfill all internship basic requirements (i.e. special projects, fitness testing, program development, special populations).
(4) The intern must inform the program coordinator as to the scheduled workdays.
(5) The intern must contact the program coordinator several times throughout the field experience to report your progress as well as any difficulties that they are experiencing.
(6) During the Internship experience the HFF student will be required to complete several projects designed to enhance their educational experience. These projects will be kept in a student portfolio and must include:
- A promotional project / marketing plan for the internship facility.
- An individual fitness program.
- A group fitness / wellness program (i.e. an exercise class, educational seminar, or team program).
- A fitness-testing portfolio.
- A summary reflection paper.
Additionally, the student-intern will be required to obtain 5 practical hours in each of the following domains:
- Senior Citizen Wellness
- Obesity/Weight-Control
RESPONSIBILITIES OF THE SPONSORING INTERNSHIP SITE
The supervising internship site shall provide the FSU Exercise & Sport Science Intern with the opportunity and available health/fitness equipment, physical facilities, materials and supplies in which to apply and practice the clinical skills related to that intern’s field of study. The sponsoring internship site will also provide each Exercise & Sport Science Intern with the opportunity to work with that facility’s clientele as appropriate. The supervising facility will have the responsibility to provide the Intern with the appropriate equipment and opportunity to fulfill all internship basic requirements (i.e. special projects, fitness testing, program development, special populations), as well as to designate the administrative daily activities. Furthermore, the supervising facility will have the right to remove any Intern with whom they become dissatisfied and shall be relieved of any obligations to the Intern. In the event that any supervising facility’s physical facilities are deemed unsuitable for an appropriate learning experience by the Intern’s faculty supervisor, the Intern may be removed from that site and placed in an appropriate internship site. The supervising internship site also agrees to complete a midterm and final evaluation form and submit these evaluations to the faculty internship supervisor within one (1) week of the completion of the internship experience.
Each supervising internship site must provide the following items to ensure appropriate practice of clinical skills by the intern:
(1) Body composition testing equipment (i.e.: skin fold calipers, BIA device, Bod-Pod, Hydrostatic weighing, Futrex, or any other appropriate device).
(2) Cardiovascular Fitness Testing Equipment (i.e.: Lifecycle Fit-Test, YMCA Sub-Max Cardio Test, Harvard Step-Test, or any other appropriate testing protocol).
(3) Musculoskeletal Flexibility testing equipment (i.e.: Tape measure, sit & reach box, goniometer, or any other appropriate testing device).
(4) Standard Sphygmomanometer & Stethoscope.
The Exercise & Sport Science Intern will conduct a facility review during the first week of the internship at their respective internship site. A checklist of the aforementioned facility requirements will be taken. If any deficiencies in the required facilities are noted in this review, the faculty internship supervisor will personally review the facility. From this facility review, the faculty supervisor will make a written report of the deficiencies. The Internship site will have fourteen (14) days to correct the deficiencies or the intern will be placed in a new internship site.
The supervising internship facility will continue to have responsibility and liability for supervision of the facility’s daily operations, exercise equipment, physical facilities, material and supplies which it provides for the use and application of the Exercise & Sport Science Interns. Additionally, the supervising internship facility will agree to assign only duties consistent with the job description of a regularly employed health/fitness professional.
COMPENSATION
In compliance with the Department of Labor’s requirements, Exercise & Sport Science Interns will receive nine (9) hours of academic credit for their participation in this internship experience. Therefore, the supervising internship facility is NOT required to financially compensate the intern for services provided. If financial compensation is to be rewarded it is the responsibility of the Intern and the supervising internship facility to determine the appropriate pay scale and schedule.
TERM
The effective date of this agreement shall be ______. This agreement shall terminate on ______. The parties agree to discuss renewal of this agreement sixty (60) days prior to termination.
Professional Liability Insurance
Each student intern shall be required to obtain a professional liability insurance policy with coverage limits of not less than $1 million per claim and $3 million aggregate, with the policy being written on an occurrence basis and subject to annual renewal. Each Intern must present written proof of such insurance to the supervising faculty member and the internship supervisor prior to the intern’s first on-site visit to the sponsoring internship site.
NONDISCRIMINATION
Each party agrees that student recruitment, admission, participation in clinical activities, and evaluation shall occur without discrimination with respect to race, color, creed, sexual orientation, age, disability, or national origin.
Governing Laws
This agreement shall be governed by the laws of the State of Maryland, and subject to the exclusive jurisdiction of Maryland State courts.
Amendments
This agreement may be amended only in writing and signed by each of the parties to this agreement.
IN WITNESS WHEREOF, the parties, by their authorized officials, execute this agreement for Exercise & Sport Science Health/Fitness Internship.
Sponsoring Internship Site
Name of Sponsoring Site:______
Authorized Official: (print)______
Authorized Official: (signature)______Date:______
FROSTBURG STATE UNIVERSITY
Internship Faculty Supervisor: (print)______
Internship Faculty Supervisor: (signature)______Date: ______