Site Supervisor. I have discussed this internship with the student and negotiated and assigned the work components that appear in the attached job description. I agree to provide assistance and necessary training and consultation to help the intern complete the Learning Plan. I further agree to provide the intern with an orientation concerning relevant organizational policies, procedures and functions and to meet with the intern regularly and to be available to counsel, mentor and advise for the duration of the internship. I agree to conduct a mid and final evaluation of the intern and to participate in a site visit by a St. Olaf faculty person and/or the Internship Director if requested. Signature: Date: FACULTY SUPERVISOR: I have discussed, reviewed and approved the student’s Learning Plan and site job description. These statements constitute a valid learning experience worthy of academic credit in the listed academic department/program. I agree to be in regular contact with the student as outlined in the Learning Plan, evaluating the integrated project/closing activity, contacting the site supervisor if necessary, participating in an on-site visit if possible, and submitting a grade (P/N) by the grades due date. Signature: Date: DEPARTMENT CHAIR (OPTIONAL: required only if counting internship credit towards major): I have discussed, reviewed and approved the student’s Learning Plan and position description. They constitute a valid learning experience worthy of academic credit. I approve this internship to be counted towards the requirements fulfilling this student’s major. *Students: this request should be made to at least 4 days prior to when you would like it to be approved. Signature: Date: VISA COORDINATOR IN INTERNATIONAL & OFF-CAMPUS STUDIES (International Students Only): International students must be aware of special internship policies <xxxx://xx.xxxxxx.xxx/pipercenter/international-students-and-internships/> and must have the internship approved by the Visa Coordinator in International and Off-Campus Studies. Signature: Date: PIPER CENTER (last to sign, appoint. required-- request an “Academic Internship Review” appoint. in Ole Career Central): In my judgment the learning objectives described in the Learning Plan constitute a valid experiential learning experience. The position description and responsibilities set forth from the internship site meet the guidelines for a valid internship experience and introduction to the world of work. I agree to work with the student, faculty supervisor and site supervisor to ensure that objectives, strategies and evaluations of the internship are fulfilled. Signature: Date:
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Samples: Internship Learning Agreement and Plan, Academic Internship Learning Agreement and Plan, Academic Internship Learning Agreement and Plan
Site Supervisor. I have discussed this internship with the student and negotiated and assigned the work components that appear in the attached job description. I agree to provide assistance and necessary training and consultation to help the intern complete the Learning Plan. I further agree to provide the intern with an orientation concerning relevant organizational policies, procedures and functions and to meet with the intern regularly and to be available to counsel, mentor and advise for the duration of the internship. I agree to conduct a mid and final evaluation of the intern and to participate in a site visit by a St. Olaf faculty person and/or the Internship Director if requested. Signature: Date: FACULTY SUPERVISOR: I have discussed, reviewed and approved the student’s Learning Plan and site job description. These statements constitute a valid learning experience worthy of academic credit in the listed academic department/programcredit. I agree to be in regular contact with the student as outlined in the Learning Plan, evaluating the integrated project/closing activity, contacting the site supervisor if necessary, participating in an on-site visit if possible, and submitting a grade (P/N) by the grades due date. Signature: Date: DEPARTMENT CHAIR (OPTIONAL: required Required only if counting internship credit towards major): I have discussed, reviewed and approved the student’s Learning Plan and position site job description. They These statements constitute a valid learning experience worthy of academic credit. I approve this internship to be counted towards the requirements fulfilling this student’s major. *Students: this request should be made to at least 4 days prior to when you would like it to be approved. Signature: Date: VISA COORDINATOR IN INTERNATIONAL & OFF-CAMPUS STUDIES (International Required only if internship takes place outside of the United States): Students Only): International students doing an international internship for credit must be aware of special internship policies <xxxx://xx.xxxxxx.xxx/pipercenter/international-students-and-internships/> and must have meet with the internship approved by the Visa Coordinator in Office for International and Off-Campus StudiesStudies for important information prior to officially registering for the internship. Signature: Date: PIPER CENTER (last Last to signsign form, appoint. required-- request an “Academic Internship Review” appoint. in Ole Career Centralappointment required): In my judgment the learning objectives described in the Learning Plan constitute a valid experiential learning experience. The position description and responsibilities set forth from the internship site meet the guidelines for a valid internship experience and introduction to the world of work. I agree to work with the student, faculty supervisor and site supervisor to ensure that objectives, strategies and evaluations of the internship are fulfilled. Signature: Date:: REGISTRAR’S SIGNATURE (Added after submission of learning agreement to Registrar’s Office): Signature: Date: ST. OLAF COLLEGE ~ STUDENT INTERNSHIP AGREEMENT This is a Release. Please read carefully. Student must submit this completed form to the staff in the Piper Center when registering for an academic internship. I, ___________________, ID# ________________ am a student at St. Olaf College and plan to undertake an (student name – please print) Internship during: Fall Semester Interim Spring Semester Summer at the following location: _________________ ____________________________________ (Internship/Externship Site) (city/state/country) St. Olaf College itself does not control the way in which the internship work experience and the internship site is structured or operates. In granting academic credit for this internship, the College affirms that, to the best of its judgment, the experience is an appropriate curricular option for students in a liberal arts program of study and worthy of St. Olaf College credit from the Internships program in the Piper Center but makes no other assurances, expressed or implied, about any travel and living arrangements the student has made. St. Olaf College does not knowingly approve internship opportunities which pose undue risks to their participants. However, any internship or travel carries with it potential hazards which are beyond the control of the College and its agents or employees. INSURANCE COVERAGE I have sufficient health, accident, disability and hospitalization insurance to cover me during my internship. I further understand that I am responsible for the costs of such insurance and for the expenses not covered by this insurance, and I recognize that St. Olaf College does not have an obligation to provide me with such insurance. I assume full responsibility for any undisclosed physical or emotional problems that might impair my ability to complete the experience, and I release St. Olaf College from any liability for injury to myself or damage to or loss of my possessions. I understand that if I use my personal vehicle for the benefit of the agency with whom I perform my internship, St. Olaf College has no liability for personal injury or property damage which may result from that use. I agree to rely solely on my personal vehicle insurance coverage and on any insurance coverage provided by my internship agency. I understand that I will not be entitled to unemployment compensation benefits upon completion of my internship. Further, I understand that St. Olaf College assumes no liability for personal injury which I may suffer in the course of my internship and agree to be responsible for ascertaining whether my internship/externship agency provides workers compensation coverage for me. PERSONAL CONDUCT I understand that the responsibilities and circumstances of an off-campus internship may require a standard of professional decorum. Therefore, I indicate my willingness to understand and conform to the professional standards of the internship. I further understand that it is important to the success of the present internship and the continuance of future internships that interns observe standards of conduct that would not compromise St. Olaf College in the eyes of individuals and organizations with which it has dealings, and I acknowledge the College Internship Assoc. Director’s responsibility for setting rules and interpreting conduct for this purpose. I agree that should the College Internship Assoc. Director decide that I must be terminated from my internship because of conduct that might bring the program into disrepute, or the internship into jeopardy, or violates St. Olaf College policy, that decision will be final and may result in the loss of academic credit or recognition by the Office for Internships. GENERAL RELEASE I understand that St. Olaf College reserves the right to make cancellations, changes or substitutions in cases of emergency or changed conditions or in the general interest of the academic internship program. I understand that the St. Olaf College Internship program may take any actions she/he considers to be warranted under the circumstances to protect my health and safety and/or to guard the integrity of the Internship Program, including termination of the internship experience. It is further expressly agreed that the internship site and its use of any and all facilities shall be undertaken by me at my sole risk and that St. Olaf College shall not be liable for any and all claims, demands, injuries, damages, actions, or causes of actions, whatsoever to me or to my property arising out of or connected with the internship and with the use of any and all services, or facilities associated with the internship, whether or not sponsored by St. Olaf College. I do hereby expressly forever release, discharge and covenant not to xxx St. Xxxx College, its governing board, employees or agents as to any and all acts of active or passive negligence and/or liability that may arise out of injury or harm to me, death, or property damage resulting from my participation in this internship.
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