Journalism Internship Supervisor Confirmation Form
Due before or by the first class meeting day of the semester in which the internship takes place.
NorthWest Arkansas Community College
Journalism—Division of Communications & Art
One College Drive
Bentonville AR 72712
Semester of Journalism Internship______________________________
Name of student intern _______________________________________________________________
Your name (supervising authority) _______________________________________________________
Your position/title _____________________________________________________________________
Employer/Host _____________________________________________________________________
Address ____________________________________________________________________________
City/State/Zip ________________________________________________________________________
Phone (work and cell) _________________________________________________________________
Email ______________________________________________________________________________
Intern’s job title ______________________________________________________________________
Intern’s job description:
Employer/Host Supervisor of Intern: As the specified supervisor of the student enrolled in JOUR
2163—Journalism Internship, you confirm that the above-named student intern will gain valuable, useful,
and specific work experience and training in one of the forms or uses of mass media in completion of the
requirements of JOUR 2163—Journalism Internship. Furthermore, you understand the student must work
a minimum of 90 hours within the semester of the internship agreement, and you agree to track and
provide confirmation of the number of hours the student worked; that you will be responsible for assigning
work, teaching skills, training, mentoring, monitoring, evaluating and offering constructive feedback on
work completed by the student; and that the intern, as a student at NWACC, is bound by its codes of
honesty, conduct, and ethics as well as by the Code of Ethics of the Society of Professional Journalists.
The last day of the internship will coincide with the last day of classes at NWACC for the semester in
which the internship takes place, and on or before that date, you understand that you must submit an
evaluation of the student on the Internship Evaluation Form. However, you understand and agree that
the grade assigned to the intern is solely the responsibility of the Journalism Internship instructor.
Your signature indicates your understanding of—and agreement with—the above information.
Signature of Employer/Host Supervisor __________________________________________________
Printed Name____________________________________________ Date ______________________
Submit completed and signed form to Denise Nemec, Journalism Instructor, at the address above.
Contact: dnemec@nwacc.edu; 479-619-4301 (work); 479-445-9614 (cell); 479-619-2285 (fax—
Communications & Art Div.). Denise Nemec’s office is in Burns Hall, room 1120.
