Fillable Memorandum of Understanding for Paid Internship Southwest Virginia (Southwest Virginia Community College)

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Memorandum of Understanding for Paid Internship Southwest Virginia (Southwest Virginia Community College)

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Memorandum of Understanding for Paid Internship
Southwest Virginia Community College
Richlands, VA 24641-1510
This Memorandum of Understanding is made this _____ day of __________________, ____________
between Southwest Community College (SWCC), ______________________________, (the Host Site),
and ____________________(the student Intern).
WHEREAS, SWCC desires to maintain a coordinated internship program for qualified students;
WHEREAS, The Host Site and SWCC recognize the need for trained workers in the community,
and both parties desire to cooperate in furnishing an internship experience to students enrolled in the
program;
WHEREAS, the student Intern recognizes the advantages of participating in supervised
on-the-job training while enrolled in the designated program and acknowledges that he/she will be paid
by the Host Site for the time and services provided.
NOW, THEREFORE, this Memorandum of Understanding establishes the following guidelines for
internship placement and defines the responsibilities of each party──SWCC, the Host site, and the
Student Intern.
THE HOST SITE AGREES:
A. To allow the student participation and observation in the work setting of the Host S
ite.
B. To
collaborate with the SWCC Internship Coordinator to ensure the quality of internship
activities to be performed by the stud
ent.
C. To provide the student with an intern experience which will develop a practical background for
__
__________________________
_.
D. To
make the internship experience available for a minimum of _____ hours between
_______________, and _________________________.
E. Not to discriminate against any student or faculty member of the Program in regard to
race,
co
lor, religion, national origin, sex, age, financial status, or handicap with respect to any matte
r
ari
sing out of this agreemen
t.
F. The Host Site reserves the right not to accept a student for any lawful reason.
G. To
encourage the Student Intern to complete his/her college education
.
H. To
provide appropriate personnel to supervise and evaluate student intern
.
I. To
advise SWCC regarding any student whose performance is unsatisfactory, whose person
al
cha
racteristics prevent desirable relationship within the Host Site or limit the succ
essful
completion of the internship. The Host Site may dismiss a student who is deemed unsatisfactory
an
d will notify SWCC of such a dismissal
.
J. To
follow company procedures for completing payroll paperwork. The Intern will be paid by
the
H
ost Site. The rate of pay for the term of internship is ____________
.
Memorandum of Understanding for Paid Internship
SOUTHWEST VIRGINIA COMMUNITY COLLEGE AGREES:
A. To prepare the student intern academically for the student internship at the Host Site
.
B. To designate an SWCC Internship Coordinator to consult with Host Site Supervisor and to share
ad
ministrative responsibilities with the Host Site Supervisor for coordinating the stud
ent
in
ternship
.
C. To
place the Student Intern only with approval of SWCC Internship Coordinato
r.
D. To
share planning of internship hours, schedules, and assignment sites of student
s in
cooperation with the designated representative of the Host Site (Host Site Supervisor).
E. To follow Host Site policies for internship visits and/or observation
s.
F. To
instruct participating students to observe the rules and regulations of the Host Site
.
G. To
grant the Student Intern ________ credit(s) (1-5) for the coordinated internship course tak
en
d
uring his/her internship experience. A minimum of ______ hours is required
.
H. To
include the Host Site Supervisor’s evaluation of the student intern’s performance in th
e
course grade.
I. In
accordance with the Virginia Tort Claims Act, to be responsible for injury to person
s and
p
roperty arising out of activity pursuant to this agreement only to the extent that such injury
is
d
eemed to be attributable to negligence or willful acts of its agents or employees. Nothin
g
h
erein, however, shall be construed to be a waiver of the sovereign immunity of
the
Commonwealth of Virginia.
THE STUDENT INTERN AGREES:
A. To maintain regular attendance in the internship and to exercise punctuality, cooperation
,
h
onesty, diligence, and a willingness to
learn.
B. To
maintain a minimum rating of “satisfactory” from the Host Site Supervisor and a minimu
m
grade-point average of a 2.0 in college course work.
C. N
ot to initiate any position changes without the dual participation of the Host Site Superviso
r
an
d the SWCC Internship Coordinato
r.
D. To
be assigned a final grade based on a combined performance rating by the Host Site
Supervisor and the SWCC Internship Coordinator.
E. To maintain confidentiality of information gained during the internship experience.
F. If Stu
dent Intern is younger than 18, to present a consent form signed by parents or l
egal
g
uardian authorizing emergency medical c
are.
G. To
be responsible for injury to persons and property arising out of activity pursuant to th
is
ag
reement which is attributable to his/her own negligence or willful acts in accordance with
the
Virginia Tort Claims Act.
H. To complete payroll paper work according to Host Site policy. The Student Intern acknowledges
that partici
pation in this paid internship experience holds no promise of future employment, bu
t
d
oes not preclude future employm
ent.
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
_____________________________________________________________________________________
Memorandum of Understanding for Paid Internship
Differences in curriculums or Host Sites may require further comments or clarification.
Substantive changes need Division Dean approval. Please use the space below:
Information needed for SWCC Internship Report:
Checklist: (check if completed or N/A if not applicable.)
MOU with original signatures filed with Career Resource Center
Proof of insurance filed with Career Resource Center
Consent form (if intern is under 18) filed with Career Resource Center
Class roster with Empl ID’s filed with CRC
Intern’s information:
Native American Asian/Pacific Island African American
Caucasian/White Other
Male Female Age 18 or older Age 16-17
Disability: Yes No
____________________________________ _____________________________
__________________________________ ______________________________
Memorandum of Understanding for Paid Internship
Student Intern
Signature Date
Intern Name/ Empl ID:
Address:
Phone : Best time to call:
Email:
_
____________________________
Date
_
____________________________
SWCC
___________________________________
Chris Lewis
VP of Finance and Administrative Services
__________________________________
_ SWCC Internship Coordinator
D
ate
Internship Program:
SWCC Internship Coordinator:
P.O. Box SVCC, Richlands, VA 24641
Phone: 276-964- Fax: 276-964
Email:
Host Site
Signature (individual authorized to sign agreements Date
on behalf of Host Site)
Host Site:
Host Site Supervisor:
Title:
Company Address:
Phone: Fax:
Email: Web Address:
This agreement shall be effective upon all signatories’ acknowledged receipt of fully completed and
signed copy of this agreement. Initial below to acknowledge receipt of fully completed copy of this
agreement.
Student Intern
SWCC Internship Coordinator Host Site Supervisor
Agreement approved as to form by Rita Woltz, System Counsel, Virginia Community College System, November 2004.
Agreement approved for use at Southwest Virginia Community College as of January 2005.
V10.08
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Memorandum of Understanding for Paid Internship Southwest Virginia (Southwest Virginia Community College)

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Completed 27 July 2020

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