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Communication Studies Internship Program
Portland State University
Student Internship Agreement Form
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| Employer Name: ____________________________________________ |
| Employer
Address: ___________________________________________ |
| City:
______________________ State______ Zip Code: _________ |
On-site
Supervisor Name: _____________________________________ |
| Position
or Title: ___________________________________________ |
| Phone: ____________________ Fax: ________________ |
Email: ______________________
|
| Description
of Internship Duties: |
|
|
| #
of Internship Credits Student is Taking This Term:__________
Credits and Internship Hours:
150 hours = 4 credits = Approximately
15 hrs/wk.
250 hours = 8 credits = Approximately 25 hrs/wk.
400 hours = 12 credits = Approximately
40 hrs/wk.
|
| Work Schedule: |
| Arrival and Departure Time: ____________ to ______________ |
| # of Days Per Week _______________ Approx.
Hours Per Week: ___________ |
| The employer agrees to provide: |
- Job supervision throughout the student's internship experience.
- Feedback
on the intern’s performance.
- Complete a Performance Evaluation - due no later than the 9th week of the academic term.
(Evaluation Form will be provided by the Communication Studies Program)
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| |
| Internship Site Supervisor (Signature) ____________________________ Date _________ |
| Student Intern Name (Please print) ______________________________ |
| Student Intern (Signature) ___________________________________ Date
_________ |
