Original to Graduate Programs Office
Photocopies to Graduate Student Intern and Site Supervisor
Fall Spring Summer Year
By this agreement agrees to permit
Organization and Supervisor Name
to work hours per week
Graduate Student Name
from to . The number of credits to be granted for
successful completion of this work will be , based on 45 hours of internship per credit hour.
Learning objectives for this experience:
The employer agrees to employ the graduate student under the same conditions that govern other employees and to provide job supervision, appropriate
training, and varied work experiences. The employer agrees not to discriminate on the basis of race, color, national origin, sex, disability, religion, or age.
The graduate student may be dismissed for performance reasons at the employer's discretion, after consultation with the Dean of Graduate Programs.
No regular employee shall be laid off to make a place for a graduate student. The employer agrees to aid in the evaluation of the graduate student. The
graduate student will not be eligible to claim unemployment benefits following this agreement. The employer is in no way obligated to continue the
graduate student's employment or give preferential hiring treatment because of this agreement.
Signature of Employer
Telephone and Email
The graduate student agrees to diligently perform the work assigned by the employer according to the same company policies and procedures that apply
to regular employees. The graduate student promises to abide by all implied and stated terms included in this agreement. The graduate student shall be
responsible for his/her conduct during this internship experience.
Signature of Student
Telephone and Email
Peru State College:
The Dean of Graduate Programs will assist the employer with matters related to the graduate student’s internship experience and is responsible for
assigning the graduate student’s final grade.
Signature of Dean Dr. Greg Seay
Address Graduate Programs, Peru State College, P.O. Box 10, Peru, NE 68421
Telephone and Email (402) 872-2283 firstname.lastname@example.org
NOTE: This is not a legal contract. It is an agreement which may be terminated at any time by any party to the agreement. The purpose of this agreement
is to assure that there is joint understanding of the goals and objectives of the Graduate Program internship.
Peru State College is an equal opportunity institution. PSC does not discriminate against any student, employee or applicant on the basis of race, color,
national origin, sex, sexual orientation, gender identity, disability, religion, or age in employment and education opportunities, including but not limited to
admission decisions. The College has designated an individual to coordinate the College’s nondiscrimination efforts to comply with regulations implementing
Title VI, VII, IX, and Section 504. Inquiries regarding non-discrimination policies and practices may be directed to Eulanda Cade, Director of Human
Resources, Title VI, VII, IX Compliance Coordinator, Peru State College, PO Box 10, Peru, NE 68421-0010, (402) 872-2230.