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EXPERIENTIAL LEARNING AND CAREER MANAGEMENT (ELCM) REQUEST FOR (Millersville University of Pennsylvania)

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EXPERIENTIAL LEARNING AND CAREER MANAGEMENT (ELCM) REQUEST FOR INTERNSHIP
M
arch 31, 2020: Following guidance from the Chancellor’s Office, the University has determined that all 2020 Summer Session
instruction, including co-curricular activities in Summer Sessions 1, 2, and 3, will be offered only through distance and/or remote
learning (no in-person instruction) modalities. All in-person educational experiences that cannot be moved to a remote
modality, including coops, professional placements, and internships for credit, are suspended until further notice. Please
contact your faculty advisor for further guidance. Summer Session Internship information
.
Last Name First Name M.I. Student I.D. #
Address (Street, City, State, Zip) Cell Phone (Include Area Code)
Millersville University email address:
US Citizen: Yes No Student Visa: Yes No Access to Car: Yes No
Please check appropriate selection and term below:
International Internship? You must contact International Programs & Services at International@Millersville.edu
or 717-871-
7506 for information required to participate in an international credit-bearing internship.
I
f hired as an intern, please provide the following from Career Connection: Employer name, contact name and internship title.
OR found Internship on your own? It must be approved by your department internship coordinator and ELCM and may
not be with an in-home business. You must have the employer email ELCM at careers@millersville.edu
their employer
information (company name, supervisor name (MU alumni? y/n), email and phone number for supervisor, the job title and
description, if the position is paid, start/end dates and how many hours they are requiring for the internship).
Employer & Internship Job Title:
University/Colleges Attended
Overall
GPA
Major
GPA
Minor
GPA
Credits
Earned
Anticipated
Graduation Date
Major (& Conc)/Minor
1. Millersville University
2.
Do you receive financial aid? Yes No If YES, contact the Financial Aid Office to see if this will impact your financial aid.
As an enrolled student at Millersville University, I agree to the following stipulations regarding academic, credit-
bearing internships. (PLEASE READ CAREFULLY BEFORE SIGNING)
1. I
understand by utilizing the services of Experiential Learning & Career Management (ELCM) to obtain a credit-bearing
internship that I am agreeing to pay for the tuition and all associated fees. Millersville University considers the
internship a course like any other. Therefore, I am required to pay tuition for enrolled credits.
2. I hereby authorize release of information relating to me for the purpose of securing a credit-bearing
internship work assignment. In order to revoke this authorization, I must do so in writing.
3. I am aware that my request for a credit-bearing internship does not guarantee me an internship assignment;
therefore, I will follow all regular class registration and payment procedures in the event that I do not secure an
internship position.
4. I UNDERSTAND THAT IT IS MY RESPONSIBILITY to consult with my academic advisor prior to securing an internship
to determine how it may satisfy my major or the overall 120 credits needed for graduation.
Looking for an Internship:
Interviewed & hired as an Intern:
Fall
Fall
Spring
Spring
Summer (all three sessions) Must be conducted as a
100% fully remote experience.
Summer (all three sessions) Must be conducted as a 100% fully
remote experience.
5. I
t is my responsibility to locate internship opportunities and obtain an internship assignment, just as I would find
any professional career assignment.
6. It is my responsibility to file all required paperwork as required by the university and my department in order
to schedule the appropriate credit for my internship. I will adhere to all posted deadlines.
7. Approval of the internship for academic credit is contingent on the approval of the Department Internship
Coordinator and Experiential Learning and Career Management.
8. I understand that I must have a minimum 24 credits earned at MU (or 12 credits earned at MU as a transfer
student) unless there are higher departmental requirements to participate in an internship. If my MU earned credit
hours are below the minimum at time of application, my application will be held until the current term’s grades are
computed and I have achieved the required credits.
9. I understand that I must have a minimum 2.0 overall GPA and 2.0 major GPA unless there are higher departmental
requirements to participate in an internship. If my GPA is below the minimum at time of application, my application
will be held until the current term’s grades are computed and I have achieved the required GPA. If my GPA falls
below the minimum due to performance the semester preceding the internship, the internship will be withdrawn.
10. Because academic internships are designed for students in their declared major, minor or areas of concentration, I
will meet all department prerequisites prior to the internship semester including the credit and GPA standards.
11. I understand credit-bearing Internships earn a minimum of 3 credits, which may be counted as electives within my
major or minor. A maximum of 12 internship credits may be earned (i.e. maximum of four, 3-credit internships. If I
want to earn more than 3 credits for an internship assignment, I need to discuss it with my internship coordinator
as
it is at the discretion of the department to approve and written approval must be sent to ELCM).
12. I will obtain all the required documentation that may be required by my department and/or site to participate in
an internship. This may include criminal background check, professional liability insurance, first aid certification,
etc.
13. I understand that my acceptance in the internship assignment may be contingent on my ability to meet site
selection criteria such as interview, pre-employment testing, background check, and substance screening.
14. I will submit all reports and communicate with my faculty internship supervisor according to the prearranged
schedule as outlined by the credit-bearing internship program which is listed in the internship handbook. I will inform
my faculty internship supervisor and Experiential Learning and Career Management of any changes to my internship
job description and work schedule. Additionally, I will report any significant problems that I may encounter at the
internship site.
15. I understand the internship hours
will take place during the academic semester or summer term; over the course
of 12 to 15 weeks. Any hours that I complete outside the regularly scheduled academic term must be pre-
approved during the application process (see items 6 & 7 above).
16. I will keep Experiential Learning & Career Management and my faculty internship supervisor informed of
changes in my contact information (name, address, cell phone).
17. I also hereby understand and will adhere to the policies and procedures of Experiential Learning and Caree
r
M
anagement Credit-Bearing Internship Program as they appear in the Student Internship Handbook, and
hereby request approval from my department to begin the credit-bearing internship search process.
Student’s Signature Date
Email all 4 pages along 2/your degree audit to your department internship coordinator
. Ask them to type their name in
the fillable field below for their signature. Forms needs to be saved and ask them to email it to: mbote@millersville.edu
GPA Verified:
Dept. Faculty Internship Coordinator signature (Check Online for the list of coordinators) Date
GPA Verified:
Second Major or Minor Dept. Faculty Internship Coordinator Date
Millersville University Experiential Learning and Career Management (ELCM) 717-871-7655 careers@millersville.edu 5/26/2020
ELCM OFFICE USE ONLY: GPA Verified checked-in CC added qualifier ( s w) Placeholder/Banner
Academic Program: Undergraduate Studies
Credit-Bearing Internships
Page 1 of 2
Effe
ctive: October 1997
Academic Program: Undergraduate Studies
CREDIT-BEARING INTERNSHIP PROGRAM
Approved: October 1997
Reviewed: June 4, 2007
Deans’ Council, Faculty Senate
Revised: September 23, 2015
Deans’ Council, Faculty Senate
Internships are learning experiences that take place in a professional work setting rather than in a classroom.
Credit-bearing internships are the result of partnerships between the University and employers in business,
industry, government and community-based organizations. Students may participate in a credit-bearing
internship locally, nationally or internationally.
A credit-bearing internship experience becomes part of the total learning experience, giving the student’s
academic program a sense of reality and relevance. As a result of the credit-bearing internship program,
students in any major can receive professional experience, earn income and apply learned theories.
Internships also provides the opportunity for students to gain greater insight into their chosen career, allowing
them to explore different professional environments and organizational cultures, providing them with the
environment to learn how to interact with diverse personalities, and assisting them with strengthening or
redirecting their career choices.
S
ophomores and juniors are highly encouraged to take the first steps to find out more about credit-bearing
internships by completing an online orientation through Experiential Learning and Career Management. In
order to register an internship for academic credit, students complete paperwork with ELCM and obtain
approval from the appropriate departmental faculty and school dean. Students must complete this registration
process by the end of the drop/add period.
At the discretion of the department, a minimum of three (3) credits up to a maximum of 12 credits (no more
than maximum of four (4) internship experiences) may be counted in the major/minor or as electives toward
normal graduation requirements. Additional credits will be counted over and above the normal graduation
requirements. As with any course, there are academic requirements as well as appropriate tuition for each
experience.
The Credit-Bearing Internship Program is optional for most Millersville University majors. Students must,
however, meet the following minimum criteria for participation:
1. Be enrolled in a degree program at Millersville University (MU); declared a major and/or minor.
2. Transfer and second degree students must successfully complete 12 credits at MU.
3. New first-time, undergraduate students must successfully complete at least 24 credits at MU.
4. A minimum CGPA and major/minor GPA of at least 2.0 is required (departments may stipulate higher
CGPA/major/minor GPA requirements).
5. Departments may have additional credit or course prerequisites.
6. Have approval from the appropriate academic department to participate.
7. All credit-bearing internship assignments must be approved by the appropriate College/School dean.
Governance & Policies
Academic Program: Undergraduate Studies
Credit-Bearing Internships
Page 2 of 2
Program Requirements:
Students in Millersville University Credit-Bearing Internship Program earn academic credits for the internship
experience. This means that the student must complete some minimum requirements in order to earn those
credits:
1. Academic internships are generally completed for a minimum of 3 credits on campus or off campus.
2. Participation in a credit-bearing internship generally occurs over a period of 12 to 15 weeks during th
e
f
all, spring or summer terms for a minimum of 120 hours, or generally 40 hours per credit, unless
otherwise approved by the department and College/School dean. Individual departments may requir
e
m
ore hours for the internship experience. The focus is on learning and educational objectives, not t
he
num
ber of hours accrued at the employer site.
3. Internship credits will not be awarded retroactively for internship hours performed at an earlier time,
meaning a student cannot complete an internship in summer and register it for internship credit for the
f
ollowing fall semester.
4. Students must pay tuition (including summer internships).
5. Students must earn a favorable evaluation from the employer.
6. Students must initiate and have a minimum of five (5) communications/meetings with the faculty
internship supervisor establishing learning objectives, goal setting, providing progress reports an
d
ev
aluating the experience. One of these communications/meetings should be a site visit as long as t
he
company or organization is within 100 miles radius of Millersville University.
7. Departments and supervisors may require students to successfully complete and pass formative and
summative assessments.
8. Complete any additional departmental assignments.
9. Complete an evaluation/assessment of the academic internship experience.
10. Graduation may be deferred in order to do an academic internship, but students cannot participate in a
credit-bearing internship after graduation.
Student Responsibilities:
• I have signed this document indicating my understanding of the eligibility and academic
requirements of the credit-bearing internship program.
Name (sign & date): ____________________________________________________________
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Completed 23 August 2020

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