NOTE - please review all the information below before keying in your answers. Please do not complete the form until you have all of the information. Leaving the form and returning later sometimes creates errors within the form and it will not work properly.
Please complete ALL the information in fields below, if you do not know the answer to some of the requested information please consult your Internship Instructor for your program area or Employer Site Supervisor.
Please note this agreement must be completed immediately upon the acceptance of an internship. Failure to do so by the census date (12th class day) will result in the student not receiving academic credit for the internship.
A copy of this form will be send to both the Internship Instructor and Internship Site Supervisor for verification and approval.