Student intern and site supervisor must both complete this form before beginning the internship.
Site Supervisor: Please return a copy of this completed form to the student intern before the start
of the internship.
Student intern: Upload the completed Learning Agreement to the online Internship Application
and share completed form with faculty supervisor at Marymount.
COMPANY NAME__________________________________________________________________
Marymount Manhattan greatly appreciates your participation in our internship program. Your role is
integral to the student intern’s experience and success. *Please note that New York State Education
Law requires a minimum of 120 hours of supervised work in order to obtain 3 internship credits.
As site supervisor for this internship, I agree to:
1. Clearly discuss the requirements of the internship with the student intern and familiarize the intern
with the work environment.
2. Work with the student to complete on-site goals, duties, and learning objectives.
3. Provide on-going supervision and constructive feedback to the student on internship performance,
i.e., skills, initiative.
4. Talk and/or meet with the faculty supervisor if requested.
5. Complete an evaluation of the student’s performance and attitude at the end of the internship.
Site Supervisor’s Signature___________________________________________Date____________
Internship Description and List of Duties (Site Supervisor: Please include at least three specific duties
and add additional duties as appropriate).
Name________________________________________________ MMC ID #_________________
Preferred Email_____________________________________ Local/Cell Phone_______________
MMC Sponsoring Academic Department______________________________________________
Faculty Supervisor______________________________________________#credits____________
Semester/Year of Internship_________________________________________________________
As a student seeking credit for an internship experience, I agree to:
1. Complete the Internship Learning Agreement and submit it via the online Internship Application and
to the Faculty Supervisor before beginning the internship.
2. Meet with the Internship Coordinator (Ryan Atwell, Career Services) after submitting the online
Internship Application. I understand that after I meet with the Internship Coordinator, my application
will need to be digitally approved by both my Faculty Supervisor and the Division Chair before it is
sent to the Registrar’s Office to be added to my schedule.
3. Perform to the best of my ability all tasks assigned by the Site Supervisor that are related to my
learning objectives and internship responsibilities.
4. Complete all academic work as outlined by my Faculty Supervisor and required for the granting of
academic credit for the internship, e.g., papers, journals, meetings. (Be sure that you discuss the
academic requirements with your faculty supervisor before registering for an internship.)
5. Follow all regulations, rules, and normal requirements of the workplace.
6. Immediately notify my Faculty Supervisor and the Internship Coordinator (Ryan Atwell, Career
Services) of any changes or problems that may develop during the internship, especially if my site
supervisor changes. (Please provide contact information for the new supervisor immediately.
This is important for evaluation purposes and may affect your grade.)
7. Complete an evaluation of my experience at the internship.
Student Intern Signature________________________________________________Date________
Remember that the internship requires a minimum GPA of 2.0 and 30 completed credits. Transfer
students are eligible after one semester of full-time study at MMC. Students must also have completed all
necessary and outstanding CareerLab assignments. Please visit the Internship page of the Career Services
website for more information.
New York State Education Law requires a minimum of 120 hours of supervised work in order to
obtain 3 internship credits.
Your work schedule is to be negotiated with your Site Supervisor taking into account your academic
*Please note that the learning agreement must be completed in order to submit your application to
receive academic credit for your internship.