INTERNSHIP PROGRAM CONTRACT

Please read through this contract carefully and complete. Additional information on internships can be found at

Step 1 Verification by Registrar’s Office: GPA _____ Classification _____Signature/Date ______

Step 2Secure a faculty supervisor who teaches in the academic department in which this internship will be counted for credit; some academic departments have a designated faculty member each semester who handles internships. Fill in site name and address and completethe learning goals and academic requirements for your internship with your Faculty Supervisor. Acquire signatures from Faculty Supervisor, Department Chair, School Dean and Academic Advisor.

Step 3Review learning goals with Site Supervisor and complete Internship Site Information; acquire Site Supervisor’s signature.

Step 4Acquire signatures of the Director of Career Development and the Dean of Faculty

Step 5 Turn in completed contract to the Registrar’s Office; the Registrar’s Office will enroll you in your internship course

You will be charged a fee of $150 for participating in an internship unless your internship is required for your academic major.

I. STUDENT INFORMATION

Full Name______Student ID______

GC Email ______Additional Email ______

Campus box # or Complete Local Address (include apartment #) ______

City ______State ______Zip Code ______

Cell Phone w/Area Code ______Other Phone w/Area Code______

Major(s) ______Minor(s)______

Student’s Signature ______Date ______

REGISTRATION SPECIFICS

Term: Fall semester ______Spring semester ______Summer ______Year ______

Date Begins ______Date Ends ______

45 HRS = 1 CR / 90 HRS = 2 CR / 135 HRS = 3 CR / 180 HRS = 4 CR / Other:

Hours Intern Will Work (circle one):

Students must work 3 clock hours per week for each credit hour earned. For a 4 credit internship, students must work a total of 180 clock hours - 12 hours per week for the 15 week semester during fall/spring. During a summer internship, you should register for the internship for session 1 and carry it over to session 2 thus giving you 10 weeks of 18 hours each to fulfill your hours requirement

Course: (Dept such as CRI, KIN, BUS, etc) ______3800 Internship Hours: ______

II.INTERNSHIP DESCRIPTION & LEARNING GOALS- determined collaboratively with faculty supervisor

General Description of Internship ______

______

Specific Learning Goals

1.______

2. ______

3. ______

4. ______

Turn over to complete Academic Assignments

III.ACADEMIC ASSIGNMENTS- determined by faculty supervisor; submit assignments to faculty supervisor

1. Journal/Blog ______Due Date ______Faculty Initials _____

2. Assigned Reading ______Due Date ______Faculty Initials _____

3. Project(s) or alternative Assignment(s) ______

______

______Due Date ______Faculty Initials _____

4. Written Summary ______Due Date ______Faculty Initials _____

5. Oral Presentation ______Due Date ______Faculty Initials _____

IV. FACULTY SUPERVISOR, DEPARTMENT CHAIR, ACADEMIC ADVISOR SIGNATURES

Faculty Supervisor’s Printed Name ______Campus Ext. ______

Faculty Supervisor’s GC Email ______Alternate Phone ______

Faculty Supervisor’s Signature ______Date ______

Department Chair ______Date ______

Academic Advisor ______Date ______

VI. FINAL APPROVAL/SIGNATURES– turn into the Registrar’s Office when contract is complete

Director, Career and PersonalDevelopment ______Date ______

Dean of Faculty ______Date ______

REGISTRAR’S OFFICE

Is internship REQUIRED for major? ______If so, be sure ISFEE is set in course/section prior to registration.

Setup: Course ______Section ______Hours ______Instructor ______

Process complete: Copy of contract to: student, faculty supervisor, career exploration, and advisor. Original to student file.

Completed: Date ______By ______

FORM: REG502