Bachelor Degree Internship Program
__________________________ and _____________________________
(Student) (Business/ Agency)
Prerequisite: Internship Eligibility Application must be approved (attach copy).
Students are responsible for TYPING all information on the ILA, seeking signatures only from the faculty and
site supervisors, and returning the completed ILA to the academic department prior to the start date of the
internship. The school secretaries enroll students in the appropriate internship course.
This agreement may be terminated for just cause by any of the persons signing this agreement, and each agrees
to give a two week notice, where circumstances permit, to all other parties prior to termination.
Number of credits to be earned for internship: _________ credits
Term/year* in which you are seeking credit (Check one): Spring Summer Fall Year 20___
* Term must match time period in which most or all of internship is underway.
Dates of Internship: _________________ to ____________________. ___ PAID ___ UNPAID*
(month/day/year) (month/day/year)
If this is a paid internship please indicate: hourly wage $___.___ or stipend* amount _______ per/_____
*NOTE: Unpaid internships and those with stipends require an Affiliation Agreement
Important Reminders:
1. The faculty supervisor or the faculty member designated to approve internships in the department from
which one is seeking credit is the ONLY person who can give initial approval of an internship for academic
2. To ensure proper internship credit, the Internship Learning Agreement (ILA) MUST be completed and
signed by the student, faculty supervisor, and site supervisor. It is the student’s responsibility to obtain the
site supervisor’s signature after the faculty supervisor’s signature has been obtained. The faculty supervisor
then attaches the Eligibility Application to the ILA and returns it to the school secretary of the department
granting credit. The school secretary obtains signatures from first the dean, and then the VPAA. Upon receipt
of the VPAA signature, the school secretary will register the student for the internship.
3. DEADLINES for submission of Internship Learning Agreement: Dec. 1 for spring semester
internship; May 1 for summer; Aug. 1 for fall semester.
NOTE: If a student secures an internship after these deadlines have passed, he/she needs to immediately
contact the faculty supervisor to seek approval for the internship. If deadlines are passed, a late fee may be
State University of New York
College of Agriculture and Technology
Cobleskill, New York
Internship Student Learning Outcomes CITA480:
Demonstrate the ability to design, implement, and coordinate a Business/IT project
Demonstrate the ability the ability to work both independently and under supervision
Demonstrate the ability to critically analyze a Business/IT problems and recommend appropriate
Demonstrate the ability to work in a collaborative manner with cross-functional teams
Demonstrate the ability to effectively communicate in both oral and written formats
Demonstrate the ability to conduct themselves in a professional and ethical manner
Internship Objectives and Activities:
List objectives of the internship and specific activities to be completed. Indicate approximate amount of time
to be devoted to each activity. Be as specific as possible. (The faculty supervisor will provide guidance in
initial preparation of this section with input from the site supervisor.)
Form reviewed by (please initial) Student: _________ Faculty Supervisor: _________ Site Supervisor: _________
Student Name:
Anticipated Date of Graduation:
Home Address:
Term/year* in which you are seeking credit:
* Term must match time period in which most or all of internship is underway.
As a student seeking credit for an internship experience, I agree to:
Obtain approval from my faculty supervisor or the faculty member designated to approve internships in
the department granting the credit for the proposed internship and site;
Work with my faculty supervisor to complete the Internship Learning Agreement, obtain appropriate
signatures, and submit by the deadline;
Satisfy all financial obligations for the internship including tuition and fees;
Perform to the best of my ability those tasks assigned by my site supervisor which are related to my
learning objectives and to the responsibilities of this position;
Abide by SUNY Cobleskill Student Conduct Code and academic policies, and follow all the rules,
regulations and normal requirements of the internship site;
Complete the academic requirements outlined in this ILA under the guidance of my faculty supervisor;
Notify the faculty and site supervisors of any changes I need to make to this agreement or of any
concerns or problems that may develop during the on-the-job experience;
Terminate my participation only after discussing my concerns with my faculty supervisor and providing
notice when possible, to the site supervisor.
Complete both the periodic and final evaluation forms in a timely manner;
Return to campus for a final internship presentation and reporting.
Student Signature: ___________________________________________ Date: _____________
(This section must be completed by the student and signed by the faculty supervisor or designated departmental
Faculty Supervisor Name:
Primary Contact Phone:
Office Phone:
Academic Criteria: See the department’s Internship Syllabus/Course Description for specific academic
As a Faculty Internship supervisor, I agree to
Keep in contact with the student (a minimum of 3 substantive contacts during internship) to provide
guidance, support and evaluation;
Visit the internship site (if possible) and contact the site supervisor at least four times during the semester
to discuss the student’s performance (using the most appropriate means of communication);
Assess the student’s learning based upon internship duties, a daily journal or log, communication with
the site supervisor, the site supervisor’s evaluation, completed activities required by the department
including specified hours at the site, and the final student paper or other assignments. Review online
student and site evaluations and communicate appropriately. Submit appropriate paperwork for final
credit and grades.
Faculty Supervisor Signature: ___________________________________ Date: __________
(This section must be completed by the student and signed by the site supervisor or appropriate site representative)
SUNY Cobleskill greatly appreciates you hosting our intern. Your role is integral to the student’s internship experience
and success.
Site Supervisor Name:
Business/Agency Name:
As a site supervisor for this internship, I agree to:
Clearly discuss the requirements of the internship with the student intern;
Work with the student to complete on-site goals, duties and learning objectives;
Provide ongoing supervision and feedback to the student on his/her performance;
Communicate with the faculty supervisor and meet with him/her during the site visit;
Complete both the periodic and final evaluation forms in a timely manner.
Site Supervisor Signature: ________________________________________ Date: __________
For College Use Only:
As authorized representatives of the State University of New York, College of Agriculture & Technology at Cobleskill, I
approve the above agreement between listed parties.
Dean Signature: ___________________________________________ Date: __________
VP for Academic Affairs Signature: __________________________ Date: __________