Internship Description Form
Thank you for your interest in serving as an internship supervisor for our URI students.  If you have any questions about this form, please contact the University of Rhode Island Center for Career and Experiential Education by email: ccee@uri.edu or phone: 401-874-2311.
Sign in to Google to save your progress. Learn more
Please select the semester of the internship: *
Internship Supervisor Information:
Please provide the information for the student's direct Supervisor during their internship.
Name of Organization: *
Website:
Direct Internship Supervisor First and Last Name *
Direct Internship Supervisor's Title *
Direct Internship Supervisor's Phone Number & Extension *
Direct Internship Supervisor's Email Address *
Student Intern Information
First and Last Name of Student Intern *
Email Address of Student Intern *
Student Intern's Title *
Internship Position Description *
Provide a detailed description of the student's tasks, responsibilities and projects.  Please remember that an internship is an educational experience.  Include the student's professional learning goals and other educational opportunities.
Has the student interned with this organization in a previous semester? *
If you answered "Yes" above, please explain how the student's role will evolve to introduce them to new responsibilities and learning opportunities that they were not exposed to in their previous internship.
In order to receive credit for continuing an existing internship, the internship experiences must differ in some capacity. This could include an internship at the same organization, but in a different department; or in the same department with different or additional responsibilities
Please list the start and end dates for your student intern (ie: June 3 - August 9): *
In what format will the student's internship hours take place: in-person, remote, or hybrid (a combination of both in-person and remote): *
Type of Orientation/Training available for student intern *
What exposure will this student intern have to your Social Justice, Equity, Diversity and Inclusion initiatives? *
Please select the semester (FA/SP = Fall/Spring // SU = Summer) and number of field experience credits (internship hours) the student will be completing: *
Agreement:
I understand that I am responsible for completing a midterm and final evaluation for the student during the semester.  These evaluations will be emailed to me by the intern's course instructor. *
Our primary concern is providing our students with a professional learning experience. In order to do this, we ask that the placement site supervisors agree to provide the intern with a hands-on learning experience that combines practical application, observation, professional opportunities and mentorship. We also require the student to receive adequate supervision in a reasonably safe environment with the necessary tools and equipment to perform intended services. Past student interns have indicated that regularly scheduled meetings with the supervisor to discuss work assignments and performance greatly enhances the student’s experience. *
Agreement:
All students enrolled in the URI internship program will receive 3-12 academic credits for their internship experience. While we do not require the agency to pay the student intern, if the agency has the means to do so, it is appreciated but not a condition of the internship experience.  However, if your student is only earning credit, the following Department of Labor standards must be met: The training, even though it includes actual operation of the facilities of the employer, is similar to that which would be given in a vocation school. The training is for the benefit of the trainees.  The trainees do not displace regular employees, but work under close observation. The employer that provides the training derives no immediate advantage from the activities of the trainees, and on occasion his/her operations may actually be impeded.  The trainees are not necessarily entitled to a job at the completion of the training period. The employer and the trainees understand that the trainees are not entitled to wages for the time spent training. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of University of Rhode Island. Report Abuse
Google Forms