attached is the internship packet beginning fall 2016 for · pdf fileattached is the...
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AttachedistheinternshippacketbeginningFall2016forANEQ487AorB(AnimalorEquineScience).Componentsofthepacketneedtobecompletedby:InternSiteSupervisorAdvisorInternshipCoordinatorAllitemsMUSTbecompleteandsubmittedtotheinternshipcoordinatorPRIORtoastudentenrollingintheclassORbeginningtheinternshipwork.Atthecompletionoftheinternshipafinalreportorprojectisrequired.Thedirectionscanbefoundattheendofthispacket.Pleasenotethatasaninternyouareresponsibleforinitiatingcontactwithasitethatyoufeelenhancesyoureducationalexperience;internshipcoordinators,advisorsandfacultyareheretoassistwithanyquestionsortoofferadditionalresources.Roughly45hoursof“work”isrequiredpercreditseeking.PleasecontactTiare(Equine)[email protected](Animal)beka.crocket@colostate.eduwithanyquestions.Thisagreementmustbefilledoutcompletely,signed,andreturnedtotheAnimalorEquineScienceInternshipCoordinatoratColoradoStateUniversitybeforeyoustartyourinternshipinorderforColoradoStateUniversity(CSU)tosponsoryourinternship.ThissponsorshipincludesconsiderationforWorker'sCompensationinsurancecoveragebyCSUfornon-paidinternships.CleardefinitionoftheHostsite’sexpectationsandthestudent'slearningobjectiveswillmaximizetheinternshipexperienceforbothpartiesThestudent,hostsite,facultysponsor,andinternshipadvisoragreetoassumetheresponsibilitiesoutlinedbelowforthedurationofthestudent'sinternshipplacement.NOTE:Employer,Faculty,andinternshipadvisorsignaturesarerequiredpriortothestartofinternships.
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Startdate(mm/dd/xxxx)_____________________Enddate(mm/dd/xxxx)____________________________
Academicsemester___Fall___Spring___SummerCourse#_____________________________________
PositionTitle_________________________________________
Internshiptype:____Creditonly#credits______Unpaid?Yes/no
____Credit&Paid#credits______Payrate/hour$_________#ofhours/week
SPONSORINGACADEMICDEPARTMENT
STUDENTINFORMATION
INTERNSHIPINFORMATION
AcademicDepartment:AnimalSciences/EquineSciences Dean/Chair:KevinPond
InternshipCoordinator_________________________________Ph.______________________________________
CampusAddress:Email:____________________________________
OnCampusSupervisorand/orAdvisor(bothrequiredforEquine)__________________________________
Ph.________________________________________
CampusAddress: Email:____________________________________
FirstName_______________________LastName_______________________StudentID#__________________
Phone__________________________Cell#______________________Email_____________________________
Address_______________________________________________________________________________________
City__________________________________State________________________ZipCode__________________
Major(s)______________________________________Degree_______________YearinSchool_____________
Academiccourseregisteredinforinternship____________________Credithours______________Semester_____
EmergencyContact___________________________Ph______________________Relationship______________
EmergencyContact___________________________Ph______________________Relationship______________
ListanyallergiesorspecialmedicalconditionsyouwouldliketheHostSitetobeawareof____________________________
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HOSTSITEINFORMATION
Organization:__________________________________________________________________________________
Address______________________________________________________________________________________
City_____________________________________State________________________Zip_____________________
SiteSupervisor________________________________________PositionwithinOrganization:_______________
Ph_______________________________________________Email:______________________________________
PersonwithinOrganizationwhohasauthoritytoauthorizereceiptofinternships___________________________
Ph______________________________________________Email_______________________________________
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INTERNSHIPDESCRIPTIONLearningAgreement
TheSiteSupervisorandstudentshouldcompletethissectiontogether.Describethenatureof thepositionand intern’sduties. Listspecificprojectsortasksaswellastherequiredskills.Attachajobdescriptionifavailable.
IdentifyqualificationsneededforthepositionIdentifyanyrequiredskillsandphysicalrequirements
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INTERNSHIPLEARNINGOBJECTIVES1. Whatarethelearningobjectivesoftheinternship?2. Howwillthisexperiencedemonstratethestudents’knowledgeofcourseworkconcepts?3. Howdoesthisinternshipcontributetothestudentabilitytoenteracareerwithexperience?4. List 3-8 specific educational, professional, and personal goals that are observable, measurable, and able to be
evaluatedbythefacultysponsorandsitesupervisor.Beginbulletlistwithwordssuchas“assistwith,”“learnhowto,”“expandknowledgeof,”“understandtheprocessof.”.
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INTERNSHIPCONSIDERATIONSProvidethefollowinginformation1. Locationoftheactivities,e.g.outdoors,laboratories,off-sitelocations2. Potentialhazardousandexposures,ifany,andtheirconsequences.
Thisincludesexposuretomaterialsandactivities,forexample,animal,biological,chemical,physicalorradiologicalhazards.
3. Identifyanysafetyequipmentandtrainingrequirements.
4. Outlinealltrainingrequirementsincludingsafetytrainingneededwhoisresponsibleforeachactionitem
5. Vaccinations,ifanythatarerequiredinordertoparticipatedintheoutlinedinternshipandpersonpaying.6. Identifythecommunicationtreetoensureinternshipsite,familyandCSUarenotifiedintheeventofanemergency.
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EQUINESCIENCESONCAMPUSSUPERVISORRESPONSIBILITIES:
• Assistthestudentinformulatingconciseandclearlearningobjectivesfortheinternship.• Reviewthepositiondescriptionandensurethatitmeetslearningobjectives• Determine and discuss how the proposed internship is relevant to the student's educational objectives and
meritsacademiccredit.
• Determineacademicassignments,monitorstudentprogress,andprovidefinalevaluation.• Keepincontactwithinternsthroughouttheinternshipinordertoappraiseprogressandaddressconcernsand
questions
Ihavereviewedandunderstandtheinternshipdescription,jobannouncement,rolesandresponsibilitiesofthepertinentparties.IaminagreementandacceptanceofmyRolesandResponsibilitiesOnCampusSupervisorSignature__________________________________________________________________ PrintedName Signature Date
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ADVISORRESPONSIBILITIES:• Verifythestudentmeetsdepartmentalrequirementsforaninternship.• Assistthestudentinformulatingconciseandclearlearningobjectivesfortheinternship.• Reviewthepositiondescriptionandensurethatitmeetslearningobjectives• Determine and discuss how the proposed internship is relevant to the student's educational objectives and
meritsacademiccredit.
Ihavereviewedandunderstandtheinternshipdescription,jobannouncement,rolesandresponsibilitiesofthepertinentparties.IaminagreementandacceptanceofmyRolesandResponsibilitiesAdvisorSignature__________________________________________________________________
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INTERNSHIPCOORDINATORRESPONSIBILITIES:• Reviewthestudent'seligibilityforparticipatinginanacademicinternship(GPA,prerequisites,etc.)
• Maintaincopyofhostsite’scertificateofinsurance(ifrequired.)
• Maintainacopyofsafetytraininggiven,(ifapplicable)
• Maintainacopyofallagreementsbetweenthepartiesofthisinternship
• Actasprimaryliaisonbetweenthestudent,thehostorganization,andthefaculty
• ReviewtheLearningAgreementforcompletenessandaccuracyofinformation.
• Administerinternshipevaluationprocessforallparties.
• EnsurethatallAgreementsanddocumentsareinplacepriortothestartoftheinternship
• Serve as liaison for any issues that arise during an internship – e.g. workplace conflicts or
problems with supervisors or co-workers, injuries, not getting the agreed onsite hours,
ensuringtheopportunitytofulfilltherequirementsoftheinternship–numberofworkhours,
learninggoals,etc.
• Conductsitevisitswithinternstudentandsitesupervisor
• Collectemployer’sfinalevaluation
• Assigngrade
Ihavereviewedandunderstandtheinternshipdescription,jobannouncement,rolesandresponsibilitiesofthepertinentparties.IaminagreementandacceptanceofmyRolesandResponsibilitiesInternshipCoordinator____________________________________________________________________ PrintedNameSignatureDate
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HOSTSITERESPONSIBILITIESVerifythepositionanddutiesmeettheUniversityInternshipscriteria• Completeajobdescriptionthatincludes;
o LearningObjects&Goalso Professionsareastheinternwillgainexposuretoo Expectedskillstolearno Dutiesandresponsibilitiesofinterno Resources, equipment, and facilities provided by the host employer that support the
learningobjectives/goals.o Specialqualificationsrequiredfortheposition.o Specialtrainingorconsiderationsrequiredofthepositiono Datesoninternshipo Ifaconfidentialityagreementisrequired,stateditinthejobdescriptionuponposting.
• Encourage professionalism by assisting student in developing communication, interpersonal,decision-making,andotherskills
• Provideopportunitiesforincreasingresponsibility;keepingstudentdirectedtowardaccomplishinghis/herlearningobjectives
• Discloseallagreementsastudentwillbeaskedtosignintheinternshipdescription
*studentscannotsignhold-harmlessagreementswithoutCSU’sGeneralCounselreview
• Provideanorientation,anyprecautionarysafetyinstructions,trainingandongoingsupervisionforassignedduties.
• Provideasafeworkenvironment
• ProvidestudentandCSUstaffwithinformationregardinganySafetyConsiderations.o Identifytherisksofactivitiestheinternmaybeinvolvedinandidentifytherequiredsafety
training for any tools, computers, specialized equipment, vehicles, physical activities,hazardous chemicals, biologicals or radioactive materials, etc. that are part of theiractivities. Document training and include a signature that the trainingwas received andunderstood
• ProvideadequatesafetytrainingandprovideallPersonalProtectionEquipmenttothestudentandhavethemproperlyfittedpriortothestartofinternship.
• ProvideCSUwithcopiesofsafetyandtraininginstructions• Maintainopenchannelofcommunicationwithregularmeetings• Keepinternshipdutieswithinthescopeoutlined.• Completealltrainingdocumentationsafinalevaluation.
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• If the student is paid, understand the responsibility for providing worker’s compensation and
liability insurance in accordance with Colorado State Law, and provide said coverage ColoradoRevisedStatute8-40-302(7)(b)
o Complywith federalandstate lawsprohibitingdiscriminationonthebasisof race,color,sexualorientation,nationalorigin,sex,and/ordisability
o ComplywithFederalLaborStandardsAct(FLSA)• ProvideproofofWorkers’CompensationInsuranceforallpaidinternships
• Complywith Federal Laws prohibiting discrimination on the basis of race, color, national origin,
sex,disability,and/ormilitarystatus.• AnyinsurancerequirementsofColoradoStateUniversity,needstobeapprovedandagreedtoby
theOfficeofRiskManagement&Insurancepriortoplacements.• NotifyCSUinatimelymannerifanyproblemsariseduringtheinternshipplacement.• Completeafinalwrittenevaluationofthestudent'sperformance• Donothavethestudentsignanywaivershold-harmlessagreementsorotheragreementswithoutCSU’swritten
consent
• Addinternunderbusinessvehicleinsurance,ifemployeeisexpectedtooperatebusinessvehicles.
• Staywithinthehoursoutlinedintheinternshiplearningagreement.
Thisagreementdoesnotreleasethehostsitefromanyliabilityactionthatmaybetakenagainstthemfornegligenceofsafetyorworkplacepractices.I have reviewed and understand the internship description, job announcement, roles and responsibilities of thepertinentparties.IaminagreementandacceptanceofmyRolesandResponsibilitiesSiteSupervisor_________________________________________________________________________ PrintedNameSignatureDateBusinessOwner________________________________________________________________________
PrintedNameSignatureDate
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INTERN/STUDENTRESPONSIBILITIES• Registerhis/herinternshipwiththeinternshipcoordinatoroftheAnimal/EquineDepartment,
registerforcourse#_____ANEQ487A(Animal)orANEQ487B(Equine)andsubmitaLearningAgreementforapprovalpriortothestartdateoftheinternship
• Review the internship position description to ensure that itmeets the criteria for an internshipwithinhis/heracademicstudy
• Implementtasksthatfulfillthejobdescriptionandlearningobjects• Complete all pre intern requirements that are listed in the job description and in the learning
agreement• Approachinternship inaprofessionalmannerthat isguidedbycourtesy,adesireto learn,anda
willingnesstoreceivefeedbackforimprovement• Signupandcompletetherequirednumberofhoursforthecreditshoursoutlinedintheinternship
selected• Act inaresponsibleandappropriatemanner inaccordancewiththerulesandregulationsofthe
organization• CompleteallassignmentsoutlinedintheInternshipdescriptionsandSignedLearningAgreement.• Observeallsafetyrules• Fulfilltasksandresponsibilitiesassignedbyyoursite/hostsupervisorandoutlinedinthisLearningAgreement.• Conduct yourself in an ethical and professional manner, acting as a positive representative of Colorado State
University
• Notify your faculty sponsor in a timely manner of any changes to this Learning Agreement or if any problemsdevelopduringtheinternship.
• Understandthatthenumberofcredithourslistedinthisagreementwillbeaddedtoyourcoursescheduleandthat
youwillbechargedtheappropriatetuitionforthesecredits• This is a variable credit course and YOU are responsible for selecting the appropriate number of credits
basedonthelearningagreement
• Completeallassignmentsoutlinedinthisagreement.• Completetheevaluationofyourinternshipexperience
• Secureallvaccinations,insurances,trainingandequipmentrequiredandoutlinedininternshipdescriptionIhavereviewedandunderstandtheinternshipdescription,jobannouncement,rolesandresponsibilitiesofthepertinentparties.IaminagreementandacceptanceofmyRolesandResponsibilitiesStudent_______________________________________________________________________________
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*StudentsmustbeenrolledinANEQ487thesemestertheinternshipiscompleted!PurposeofReportEachstudentistosubmitafinalreporttohis/herInternshipCoordinatorandinEquineSciencestheOnCampusSupervisor.ThepurposeofthisfinalreportistosummarizetheinternshipexperiencefortheInternshipCoordinatorandforothers,includingfuturestudentsinterestedinasimilarinternship.Generally,thereportisnotdistributedtothecooperator.Neworuniqueexperiencesshouldbeemphasized,particularlythoseconcerningtheobjectivesoftheinternship.Thereportgivesthestudentanopportunitytowritehis/herreflectionsontheprogramandexpressthosethingsthathavethemostmeaningnowthatthisexperienceiscompleted.PreparationManystudentskeepcopiesoftheirweeklyreportsormakealogoftheprincipleexperiencesduringtheinternshipandusethesenotestowritetheirfinalreport.Somestudentsbeginthewritingoftheirreportduringthelasttwoorthreeweeksoftheprogramandtrytocompleteitduringthefinalweekoftheinternship.Suchplanningwillgivethestudentachancetoaskfurtherquestionsorclarifypointsthatmaynotbewellunderstoodwhilestillinthepresenceofthecooperator.Themajoradvantageofwrappingupthereportwhilestillontheinternshipisgettingitcompletedbeforereturningtocampus.Delayedreportsbecomeanaddedburden.AnIncompletegradeisgivenincaseswherethefinalreportandthecooperatorandstudentevaluationsarenotinthehandsoftheInternshipCoordinatorby“finals”week.Format,ContentandLengthThereportshouldincludean“introduction,”a“discussion”ofthedifferentaspectsoftheinternshipanda“conclusion”.Theintroductionwillserveasanopeningstatementandshouldincludewhereandwithwhomtheinternshipwasaccomplishedandtheobjectivesofthelearningexperience.Acknowledgementstothecooperatorshouldbeindicatedintheintroduction.Themajorcontentofthereportshouldrelatethoseitemsthatseemofprimeimportancetostudentsintermsofwhatwaslearned,uniqueexperiencesgainedandnewmethodologyobserved.Thispartofthereportprovidestheopportunitytowriteconsiderabledetailaboutafacetoftheinternshipexperiencethatwasmosteducationalandmeaningful.Arehashoftheweeklyreportsshouldbeavoided.Thelastportionshouldincludethestudent’sconclusionsabouttheexperienceandanyrecommendationsthatshouldbepassedonforthebenefitofthenextstudentandtheInternshipCoordinator.Dependingonhowmanycreditsthestudentisworkingtoward,thelengthofthetypedreportshouldbebetweenthree(3)andtwenty(20)pages,doublespaced.Typically,thepaperis2-3pagespercredit.Pictures,brochures,etc.areencouraged.Careshouldbegiventocorrectspelling,punctuationandgrammar.AnimalSciencestudentsmayelecttodoapresentationinsteadofapaper.Consultwiththeinternshipcoordinatorforspecificdirectionsontheserequirements.IftheInternshipCoordinatorfindsthepapertobeunsatisfactory,theywillreturnittothestudentforcorrections.Agradewillnotbegivenuntilthesecorrectionsaremade.
Animal/EquineScienceInternshipREADTHISDOCUMENTCOMPLETELYBEFORESIGNING.ITSEFFECTISTORELEASECOLORADOSTATEUNIVERSITY,ITSGOVERNINGBOARD,ANDTHESTATEOFCOLORADOFROMANYLIABILITYRESULTINGFROMYOURPARTICIPATIONINTHEACTIVITIESDESCRIBEDBELOW,ANDTOWAIVEALLCLAIMSFORDAMAGESORLOSSESAGAINSTTHEUNIVERSITYWHICHMAYARISEFROMSUCHACTIVITIESEVENIFTHEYRESULTFROMNEGLIGENCE.
Guidelines for the Final Report of Internship Experience
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RELEASEFROMRESPONSIBILITY,ASSUMPTIONOFRISK,ANDWAIVERPARTICIPANT’SFULLNAME:______________________________DATEOFBIRTH(MO/DAY/YR):__________________________ADDRESS:__________________________________________________________________________________LOCATIONOFACTIVITY(IES):________________________________DATE(S)OFACTIVITY(IES):STARTDATE:
ENDDATE:
Checkone: CSUSTUDENTDESCRIPTION OF ACTIVITIES: Animal Science internship with __________________________________ which may includeexposure toanimals, andanimalsareunpredictable. Itmayalsoexposeme tohazardousmaterials, equipmentand situationsthatcouldbedangerous.INSURANCEINFORMATION:IFSTUDENT:IamawarethatasastudentofColoradoStateUniversity,Icanpurchaseaccidentinsurance,eitherthroughColoradoStateUniversity (ifavailable)or throughanother insurancecarrieroragent,and (checkone) have havenotexercisedmyrighttodoso.NAMEOFINSURANCECARRIER:_______________________________ POLICYNUMBER:_____________I,theundersignedparticipant,exercisingmyownfreechoicetoparticipatevoluntarilyintheactivitiesdescribedabove,andpromisingtotakeduecareduringsuchparticipation,herebyacknowledgethatIhavebeeninformedofthenatureoftheactivitiesandthatIamawareofthehazardsand riskswhichmaybeassociatedwithmyparticipation in theabove-namedactivities, including the risksofbodily injury,deathordamage topropertywhichmay occur from known or unknown causes. I understand, accept, and assume all such hazards and risks, andwaive all claimsagainsttheStateofColorado,TheBoardofGovernorsoftheColoradoStateUniversitySystem,andColoradoStateUniversity,andotherpersonsasset forthabove. I understand that I amsolely responsible forany costsarisingoutofanybodily injuryorpropertydamage that Imay sustainthroughmyparticipationinnormalorunusualactsassociatedwiththeabove-namedactivities,regardlessofwhosefaultmaybethecauseofmyinjuriesordamages,EVEN IFCAUSEDBYCARELESSNESSORNEGLIGENCE,so longas theconductwhichcausedthe injuriesordamageswasnotgrosslynegligent,orwillfulandwanton.Further,IherebyindemnifyandholdharmlessTheBoardofGovernorsoftheColoradoStateUniversitySystemandColoradoStateUniversity,andtheirmembers,officers,agents,employees,andanyotherpersonsorentitiesactingontheirbehalf,andthesuccessorsandassignsforanyandalloftheaforementionedpersonsandentities,againstanyandallclaims,demands,andcausesofactionwhatsoever,whetherpresentlyknownorunknown,ofanypersonwhosuffersanyinjury,disability,deathorotherharm,topersonorpropertyorboth,asaresultofmyparticipationinand/orpresenceattheabovelistedactivities.Ihavehadsufficienttimetoreviewandseekexplanationoftheprovisionscontainedabove,havecarefullyreadthem,understandthemfully,andagreetobeboundbythem.Aftercarefuldeliberation,IvoluntarilygivemyconsentandagreetothisReleaseFromResponsibility,AssumptionofRisk,andWaiver.IHAVEREAD,UNDERSTOODANDAGREEDTOTHEABOVETERMSTHIS
DAYOF
,20
.SignatureofParticipantwhoseprintednameappearsabove: Signature(date) Witnessover18yearsofage(ParentorGuardianmustsignin thepresenceoftheWitnessIfparticipantisundertheageof18,hisorherparentorlegalguardianmustalsosign:I,(printedname)___________________________________________,amtheparentorlegalguardianoftheparticipantwhohassignedabove.IhavereadandIunderstandtheprovisionsofthisdocument,andactingonbehalfoftheparticipant,Iconsenttotheparticipanttakingpartintheactivitiesdescribedabove,andIfullyenterintoandagreetotheaboveReleaseFromResponsibility,AssumptionofRisk,andWaiverasauthorizedpursuanttoC.R.S.section13-22-107._________________________________ _______________________________________