Agreements and Signatures. A. DISTRICT OF CHOICE/PLACEMENT – This signature is required for both discretionary and mandatory agreements. The Board of Trustees: DISAPPROVES APPROVES this application subject to receipt of transportation/tuition charges stated on the application. Print Name of Chairperson, Board of Trustees: Signature of Chairperson, District of Choice/Placement: Date:
Agreements and Signatures. Student Intern: I concur with and accept the academic and work assignments indicated above. I understand and will adhere to the internship registration procedure and the policies outlined on the Experiential Learning Waiver. I accept the obligation of confidentiality in my work and will familiarize myself with and adhere to the organization’s relevant policies/procedures and appropriate standards and ethical conduct. _______________________________________________________________________________ Student Intern Signature Date Internship Site Supervisor: I have discussed the internship with the Student Intern and we have agreed upon the assigned work components appearing above. I agree to provide training and consultation to the Student Intern in order to achieve the above learning objectives, provide information concerning our organizational policies and procedures, meet with the Student Intern regularly, and provide a written evaluation of the Student Intern at the end of the term. (I understand that an “employer evaluation” will be mailed to me). _______________________________________________________________________________ Internship Site Supervisor Signature Date Faculty Internship Sponsor: I have discussed the academic component of this internship with the student intern. We have reached agreement on the learning objectives as indicated above. I further agree to meet regularly with the Student Intern to discuss the internship experience. I will conduct an assessment/evaluation and do an on-site visit if possible. _______________________________________________________________________________ Faculty Internship Sponsor Signature Date ___________________________________
Agreements and Signatures. Employer: I have reviewed this Internship/Field Work Agreement with the student and we have agreed upon the assigned work and learning components appearing above. I agree to provide assistance, training, consultation and periodic review in order to assist the student in meeting his or her goals and primary learning objectives; and provide an orientation to our organization, policies and procedures. I understand that the student must report to the place of business and working from home or in a home-based business does not constitute an internship. I will submit an end of term review of the student’s work performance after discussing it with the student. Employer signature Date Division Faculty Internship/Field work Supervisor: Faculty Signature Date Division Chair: Chair Signature Date Student: Student Signature Date Assistant Xxxx: Assistant Xxxx Signature* Date *I acknowledge that the requirements for this class comply with all established University, college, and divisional policies related thereto, including but not limited to the credit hour policy, academic policies, and Xxxxxx student policies and procedures. PEPPERDINE UNIVERSITY XXXXXX INTERNSHIP/FIELD PROGRAM ASSUMPTION OF RISK, WAIVER OF LIABILITY,
Agreements and Signatures. Employer: I have reviewed this Internship/Field Work Agreement with the student and we have agreed upon the assigned work and learning components appearing above. I agree to provide assistance, training, consultation and periodic review in order to assist the student in meeting his or her goals and primary learning objectives; and provide an orientation to our organization, policies and procedures. I understand that the student must report to the place of business and working from home or in a home-based business does not constitute an internship. I will submit an end of term review of the student’s work performance after discussing it with the student. Employer signature Date Program Director: Director Signature Date Student: Student Signature Date International Programs Xxxx: Xxxx Signature* Date *I acknowledge that the requirements for this class comply with all established University, college, and divisional policies related thereto, including but not limited to the credit hour policy, academic policies, and Xxxxxx student policies and procedures.
Agreements and Signatures
