BACK TO SERVICE LEARNING

Please Note: This learning contract must be negotiated and completed by the intern and supervisor (together) and approved by the director of Service Learning before the internship agreement is binding. This agreement needs to be completed before beginning or early in the internship assignment. Once you have completed this form you will receive an email with a link to download the form. Please keep this agreement for future reference.

Internship Learning Contract

Student Information
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Supervisor Information
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Internship Overview
Internship Title/Position
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Number of credits @ 105 hr/credit
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Specific Areas of Responsibilities
Overview: List the activities and experience the intern, under supervision, will be involved in during the internship assignment
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Specific Assignment Details: What will each week look like, how will the intern specifically spend the hours?
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Desired Outcomes
A job description will also be submitted
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In this section think in terms of character, task-skill, relational and knowledge goals and outcomes.
Intern: List the areas you want to experience, learn and grow in this internship assignment. Be specific.
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Supervisor: Please indicate the outcomes you desire the intern to achieve through this experience. Be specific.
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Future Vocational Ties
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How does this internship tie to your major and/or your vocational goals?
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Report Dates
We commit to handing in our reports on the following dates
Intern (please list all reports and due dates) a minimum of 5 reports/school year; 3 reports/summer
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Supervisor (please list all reports and due dates) a minimum of 3 reports
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Mentor Meetings
We have agreed to have our weekly supervisor/intern mentoring meetings at this day and time of the week, and commit to keeping those meetings going throughout the internship contract period.
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Reading
The Intern is expected to read at least 125 pages for every internship credit and so the Supervisor is assigning the following books to fulfil the additional reading assignment:
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Practical Arrangements
1. Transportation: (please outline the provisions for transportation if applicable)
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2. Financial Arrangements: (describe the renumeration arrangements, if applicable)
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Specific comments on the above financial agreement
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3. Housing (please outline provisions for room and board, if appliable)
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Other areas requiring definition
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Stipulations
The student has talked to their Program Director about this Internship Placement and the Program Director has approved it as a valid internship placement.
Student has requested Program Director email approval of internship to Doug Epp:
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By typing my name below, I (both student and supervisor) am indicating that I have read the Columbia Internship Manual and clearly understand the GUILDELINES and REQUIREMENTS of the internship program as outlined and will do my best to fulfill those expectations. Termination of this contact requires mutual consent by the supervisor and intern. The director of Internship should be consulted before such action is taken.
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After clicking submit you will be presented with a confirmation screen with a link to your completed form. If the confirmation screen does not appear, please contact doug.epp@columbiabc.edu immediately.