ࡱ> PRO` ?bjbj 8DO@@@@HHH8<<"Mlc8!!!!!!!9#h%!Q+"M!@@9="@8!! |x~! LLH6!!,S"0"H!63&3&$~!3&~!@!!c^"HH@@@@@@ Minimum requirements: COLLEGE OF ARTS AND SCIENCES 1. Undergraduate student Internship contract 2. Sophomore standing 3. Cumulative GPA of 2.0 Department: Sociology & Social Work Date:  FORMTEXT       Student's name:  FORMTEXT       Cumulative GPA: FORMTEXT       Student s local address: FORMTEXT       Local phone:  FORMTEXT       Location of internship:  FORMTEXT       From:  FORMTEXT       to  FORMTEXT       (dates) Hrs. work per week: 32 hours Sem. hrs. credit: 9 Compensation: none Housing? __ Yes _X_ No Faculty Contact Name: Denis G. Dews, MSW Address: 09D Chapell Wilson Hall Boone, NC 28608 Phone: 828.262.7658 Fax: 828.262.6811 email: dewsdg@appstate.eduAgency Contact Name:  FORMTEXT       Address:  FORMTEXT       Phone:  FORMTEXT       Fax:  FORMTEXT       email:  FORMTEXT       Guidelines: Internships will be 1 s. h. (minimum) to 12 s. h. (maximum). The faculty supervisor will enter the S/U grade upon completion of all internship requirements Internship credit will not be granted retroactively; students must have internships approved in advance. The maximum credit for an internship during one summer session will be 6 s. h. All 12 s. h. internships must span an entire term; in the case of summer, this includes the entire Summer Semester. All interns must have a faculty supervisor and a separate field/agency supervisor. Each intern will have contact with the faculty supervisor on a bi-weekly basis (minimum) during the internship. The faculty supervisor will visit each field placement to meet with the intern and the site supervisor at least once each semester, unless there are extenuating circumstances. Academic credit will be based on a minimum of 50 field placement hours per semester hour credit for the Fall and Spring semesters and a minimum of 40 field placement hours per semester hour credit in the Summer Semester. Internship written requirements set by the department (papers, journal, essays, etc.) must be completed 60 days (maximum) following the completion of the field work. The provisions for this contract will be used for all College of Arts and Sciences undergraduate internships; each department shall determine individual written requirements and expectations. (Please complete reverse side.) Responsibilities of the University: Provide the student with a pre-internship orientation. Participate in developing the learning objectives and the methods of evaluation for the internship. Provide a supervised internship experience through site visits, email, telephone contact and written communication with a faculty supervisor on a bi-weekly basis. Provide the participating agency with appropriate instruments for evaluating the student. Assist the student in developing topics for appropriate research projects, readings, and written papers relating to the agency and the internship experience. Responsibilities of the participating agency: Assign a supervisor to work directly with the student to achieve the educational goals of the internship by assigning appropriate work duties. Provide the student with an orientation to the work-site duties, hours, and agency expectations. Schedule regular meetings with the student, and provide an appropriate evaluation of the student's performance. Provide a safe, secure workplace at which the student can meet his/her educational objectives. Responsibilities of the student: Complete all of the departmental prerequisites of the internship program. If requested, provide the agency with a resume and any other necessary documents. Meet with the faculty supervisor and the agency to develop appropriate learning objectives. Abide by the personnel policies of the agency; maintain regular and prompt attendance; contact the appropriate supervisor when questions arise. Perform all of the duties and responsibilities of the position in a professional manner. Maintain confidentiality with regard to sensitive information gained in the work environment. Participate openly and honestly in the evaluation process. Complete all of the written assignments, and submit them to the faculty supervisor within the time-specified guidelines; all work shall be submitted no later than 60 days following the completion of the internship. Maintain contact on a bi-weekly basis with the faculty supervisor, and assist in arranging site visits. This agreement is subject to the specified educational objectives, duties, learning outcomes, and evaluation methods on the accompanying page(s). The agreement may be terminated by any party with two weeks notice. The University or the Agency has the right to terminate a student's experience if either party feels the student is not performing satisfactorily. Signatures: Student: ______________________________________________________ Date: _________________ -W~      0 2 F 󦕉r\MBhE$5CJ\aJjhE$5CJU\aJ+jhE$5:CJU\aJmHnHu,jhE$hl5:CJU\aJhE$5:CJ\aJ jhE$5:CJU\aJh$5:CJ\aJh$5CJ\aJhk|$CJaJhk|$5;CJ\aJhk|$5;CJ\aJhk|$5CJ\aJhk|$5CJ\aJhk|$5:CJ\aJW  R T > @ " $ D F F$If $$Ifa$#$d%d&d'dNOPQ<<?F H J T V d   * , @ B D N P R T ۻۻ۰ۻۻۻq۰ۻ\)jFhE$hl5CJU\aJ)jhE$hl5CJU\aJ)j^hE$hl5CJU\aJ)jhE$hl5CJU\aJhk|$5CJ\aJhE$5CJ\aJ(jhE$5CJU\aJmHnHujhE$5CJU\aJ)jvhE$hl5CJU\aJ$      h     " $ F P &DPڛynnnnhm5CJ\aJhk|$56CJ\]aJhk|$CJaJhE$5>*CJ\aJ)j.hE$hl5CJU\aJ(jhE$5CJU\aJmHnHu)jhE$hl5CJU\aJhE$5CJ\aJhk|$5CJ\aJjhE$5CJU\aJ+FHvxBDFHJL $$Ifa$$IfPt024>@XZ\prt~ѭ˜у˜n˜Y)jhE$hl5CJU\aJ)jhE$hl5CJU\aJ)jhE$hl5CJU\aJ(jhE$5CJU\aJmHnHu)jhE$hl5CJU\aJjhE$5CJU\aJhE$5CJ\aJhk|$56CJ\]aJhk|$5CJ\aJhm5CJ\aJ"  \]%&GH%&  pqop>Ű𢚎}}}}}}}}}}}}}}}hk|$CJaJhk|$:CJaJhk|$5:CJ\aJhk|$CJaJhk|$56CJ\]aJ)jvhE$hl5CJU\aJhE$5CJ\aJhk|$5CJ\aJ(jhE$5CJU\aJmHnHujhE$5CJU\aJ1  \]%&zzzzzh^h & F h^nkd$$Ifl0\(dd04 laGH%&  pqop> & F^ & F^$a$ & F h^h^h/0"lm gh{|P & F^h^h & F^/0"lm gh{|PQ<<<<<<<<<<<<<<<<<<=== >K>}h$6CJ]aJh$CJaJh$CJaJh$h$CJaJh$56CJ\]aJhljhlUjh"M!UmHnHuUhk|$5CJ\aJhk|$5CJ\aJhk|$5:CJ\aJhk|$CJaJhk|$CJaJ1PQ^_Z<[<<<<<<<<<<<<<<<<<<<$a$@ ^@ `$a$$^a$Faculty Supervisor: ____________________________________________ Date: _________________ Agency Representative: _________________________________________ Date: _________________      Note to the student and the faculty supervisor: This contract must be accompanied by an explanation of the following: Educational objectives of the internship How the objectives will be accomplished (duties, papers, reports, journals, etc.) Methods of evaluation and names of evaluators A completed Special Course Form shall be submitted to the Dean's Office with these documents. NOTE: All students participating in an internship are required to purchase liability insurance arranged by the university. Cost is approximately $15 per semester, and will be added to the student's account. <<<D=m===K>????$ & Fa$$a$ K>????hk|$CJaJh"M!h$h$5CJ\aJ60&PP/ =!"#$@% *2vDText13tDText1tDText2tDText3tDText4tDText5tDText6tDText7tDText8tDText9vDText10vDText11vDText12$$If!vh5d5d#vd:V l05d/ 4@@@ NormalCJ_HaJmH sH tH DA@D Default Paragraph FontRi@R  Table Normal4 l4a (k(No List 4@4 Header  !4 @4 Footer  !.)@.  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