This agreement must be filled out COMPLETELY, signed and returned to
the Office of Career Services before you start your internship. Questions?
Contact the Office of Career Services in the Bair Family Student Center or
at 406.657.1039 or careerservices@rocky.edu.
April 2015
Student Internship Learning Contract
Internship End Date:_____________________________
Academic Semester ___________(SEM)/__________(YR)
Internship start date: _______________________
Course #:____ _/450
Total Number of credits: _________
Work Hours: _______________ (Must work 45 hours per credit.)
Internship Student’s Name:___________________________________ Are you a U.S. citizen? Yes ___ No ___
Phone:__________________________ Email:_______________________________________________
Major_________________________ Minor ____________ Anticipated Graduation Date:_________________
On-Site Supervisor’s Name and Title: _________________________________________________________
Organization:____________________________________________________________________________
Address: _____________________________ City: __________________ State: _________ Zip: __________
Email:______________________________________________
___________
STUDENT RESPONSIBILITIES:
I will fulfill the tasks and responsibilities assigned by my on-site supervisor and outlined in this learning agreement. I
will conduct myself in a professional and ethical manner at all times.
As an intern with the organization listed above, I will treat all knowledge, information, and material gained through
my work assignment so as to protect its confidentiality. I understand that information acquired and compiled in the
course of my work assignment is the sole property of the organization, and I agree to make no public release of any
portion thereof, nor shall I publicly discuss or distribute any information as to compromise its confidentiality.
I also understand that the awarding of an internship does not guarantee or imply any future employment
opportunities with this organization.
I understand my grade will be based, in part, on evaluations by my on-site supervisor and any assignments required
by my faculty internship supervisor.
I will contact the Office of Career Services and my faculty supervisor in a timely manner of any changes to the
Learning Contract or if any problems arise and ensure that all evaluations are returned to the Office of Career
Services by the deadline.
I understand and agree to comply with the RMC Student Employment/Internship Insurance Guidelines, found at
rocky.edu/student-life/career-services/internships
I have read, understand and agree to abide by the guidelines described above.
_____________________________________ __________________________
Student signature Date
BSA
Phone number:_______________________
Paid ☐ If Paid, wage _____________ Unpaid ☐
Attach a job description or description of tasks and responsibilities to be completed during the internship.
Learning Outcomes of Internship - to be developed by student and faculty PRIOR to supervisor signature
A.
Demonstrate effective problem solving and critical thinking
B.
Articulate an understanding of the connection between coursework and the internship experience
C.
Demonstrate professional skill in the discipline(s) associated with the internship
D.
Practice professional habits and engage in professional behavior
E._____________________
Communicate effectively orally and in writing
_________________________ ______
