Student Internship Agreement Form
College of Business 100 Campus Center Seaside, CA 93955-8001 (P) 831-582-4232 (F) 831-582-4379
The following Student accepts an internship as outlined below, to be completed while concurrently enrolled in an internship experience course. Upper division credit for the internship course may only be earned if the student has junior or senior status at CSUMB. During the period of the internship, the intern must work at least 200 hours. Internships are either operational (the intern spends time in a number of departments) or project-oriented (the intern focuses on a limited number of departments or projects). In every case it is expected that the intern will be supervised and complete challenging projects while also contributing to the Employer operation. Intern’s Name:
_____________________________________________
Employer's Name: _____________________________________________ Employer's Address: ____________________________________________ Employer's Contact Information: _________________________________ _________________________________ _________________________________ _________________________________ Employer's Supervisor In-Charge of Intern: __________________________ Supervisor’s Title & Contact Information:
___________________________ ___________________________ ___________________________ ___________________________
Type of Intern Experience: Operational (the intern spends time in a number of departments) Project-oriented (the intern focuses on a limited number of departments or projects) Other (Please Describe) ______________________________________________ Anticipated Department(s) you will be working in:
_______________________________
Anticipated Schedule/Hours: _______________________________
Begin Date of Employment:
_______________________________
End Date of Employment:
_______________________________
Paid or Unpaid:
_______________________________
Proposed Compensation:
_______________________________
Brief description of the internship responsibilities, including special projects the intern might participate in: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ CSUMB Student Agreement: Print form, submit, and then sign printed copy and email scanned document to instructor of record (if the internship is for credit) or
[email protected] (if the internship is not for credit). The Student agrees to: • •
Work with his/her mentor in the development and execution of his/her Learning Outcomes Agreement Meet with his/her mentor at least weekly to receive guidance and direction
The Student agrees to abide by the following Limitations: • •
•
DON’T tolerate verbal exchange of a sexual nature or engage in behavior that might be perceived as sexual with an Employer representative DON’T tolerate verbal exchange or engage in behavior that might be perceived as discriminating against an individual on the basis of his/her age, race, gender, sexual orientation, ability, or ethnicity. DON’T drive vehicles to perform duties for the Employer, unless explicitly covered for liability by the Employer for that purpose. CSUMB does not provide auto liability coverage for students.
Please immediately contact your site supervisor and internship course instructor if you believe that your rights have been or may be violated.
CSUMB Student acknowledgement: I, ______________________________________________ (Student Name), agree to the following: •
• • • •
I will act in a responsible manner while representing CSUMB in this internship, and abide by all the rules and regulations that govern the associated Employer I understand the connection between the academic internship course and the Learning Outcomes to be fulfilled I have read the above stated guidelines and limitations and understand my role as a student intern I understand and acknowledge the risks involved with this internship, and enter into this relationship fully informed and aware. I agree to devote a total of _______ hours during the ________________ term in order to fulfill the internship responsibilities described above.
Student Signature: _________________________________________________ Date: _________ FACULTY / COURSE SUPERVISOR: I have examined and approve this Internship Agreement and the associated Learning Outcomes Agreement. Faculty/Course Supervisor Signature: __________________________________ Date: ________