State University of New York
College of Agriculture and Technology
Cobleskill, New York
Bachelor Degree Internship Program
Student Name (Last)
Student ID#
Term/year in which you are seeking credit/course substitution
For requests of partial waiver and or partial course substitution,
complete this section.
I am requesting _____credits of Internship “waiver” for related work experience be granted
toward the internship requirement (6 credits max.) and understand that I will need to be registered
for these credits (e.g. Internship and reporting ECHD 461, 3cr., ECHD 460, 3 cr.). The remainder of
the internship will be completed by substituting _____ credits of the course(s)/activities listed below
or by ____ credits of a partial internship, which I will need to be registered for (e.g. ECHD 461, 3cr.,
ECHD 460, 3 cr.). Approval for course substitution for part of the internship must be completed by
mid-term in the semester preceding the internship.
For requests of course substitution only, complete this section.
I am requesting a substitution of course work for my internship. The courses listed below (I
must be registered for these courses the semester I would be doing my internship) will be used for
the credits required for my degree program (e.g. 12-15 credits)
Course Number Course Name Credits
Course Number
Course Name
Course Number Course Name Credits
Course Number
Course Name
According to the Middle States Commission on Higher Education courses, programs, and other
learning experiences are judged on their learning outcomes, using valid evaluation measures. College
level learning is defined for the granting of credit for transfer of prior learning or advanced
placement secondary learning, and it is clear that credit is awarded for learning, not experience.
For faculty completion:
Describe setting in which student’s prior learning was accomplished:
Describe measure used to evaluate student’s prior learning (portfolio of work or written report) that
satisfies “Student Learning Outcomes” for internship:
Please attach the portfolio or written report submitted by student so that all parties signing
document can review.
Student Signature
□ Approved □ Disapproved
Advisor Signature
□ Approved Disapproved
Department Chair Signature
□ Approved □ Disapproved
School Dean Signature
□ Approved □ Disapproved
Vice President for Academic Affairs Signature
Note: Students cannot use coursework from a previous semester for internship.