University of Colorado at Boulder

College of Arts and Sciences

Credit Internship Application

This application must be completed, signed and returned to the department awarding the academic credit in order for the internship to be sponsored by the University of Colorado at Boulder. Completion of this agreement is also necessary to ensure a high quality experience and satisfaction among all parties. Students pursuing approval for a non-credit internship should not use this form and, instead, should contact Career Services.

1. All internships for credit in the College of Arts and Sciences have prerequisites that students must meet before they are eligible to apply. For information about the prerequisites for internship credit, visit interncons.htm or contact the specific department.

2. Students are required to have a minimum cumulative GPA of 2.00 to be eligible to apply for an internship for credit. Departments may have a higher GPA requirement.

3. A minimum of 30 hours of credit or specific prerequisites or co-requisites is the base requirement for enrolling in an internship.

4. You must obtain a Faculty Sponsor from your major department and ask her/him to assist you in completing this application. Faculty sponsors of internships should be rostered faculty.

5. All internships must provide work experience clearly related to your academic goals and prior course work. Internships for credit must include an academic component which involves reflection and analysis with regard to how the concepts the student has learned in the sponsoring discipline apply to the experiental nature of the internship. Discuss this with your faculty sponsor.

6. Make sure that you read the responsibilities under this agreement at the end of the Credit Internship Application and print everything out.

7. To receive credit, all internships must have PRIOR approval. No retroactive credit is available for internships already started or completed. In the case of internships that overlap two semesters, the student should be enrolled for the term in which the internship will be completed. If the conditions are such that a student must be enrolled in the first of two semesters, the professor must assign a grade of Incomplete for that semester and not award a final grade until all work for the internship has been completed.

8. Internships may be taken for 1-6 hours of academic credit. Determination of whether the credit hours are commensurate with academic work should be made by the instructor in consultation with the department’s associate chair or internship coordinator, who must be at least a rostered instructor. A maximum of 9 internship hours can apply toward the degree in Arts and Sciences, with no more than 6 hours acquired in one department.

9. Students must work a minimum of 40 hours for each hour of academic credit.

10. On-campus internships should serve the same purposes and adhere to the same standards as off-campus internships. To ensure that there is no conflict of interest, on-campus internships should be sponsored by a faculty member who is different from the faculty member who is supervising the student’s internship work.

11. Internship credits from other institutions do not transfer into the College of Arts and Sciences.

12. Departments can, at their discretion, sponsor an internship for a student who is not a major in their discipline. Departments can choose whether to use their established course number for an internship (and waive particular requirements if necessary) or to consult with the Curriculum Office as to the designation of course number.

13. Only after all approving signatures have been obtained and you have a copy of the approved contract will you be able to secure permission to add credits from the sponsoring department.

14. Once you have a copy of the approved application, you must register for the specific course number given by your department for credit internships. You will pay tuition for the internship according to the number of credit hours you are seeking. See tuition rates in the UCB catalog or contact the Bursar’s Office.

15. Check your department’s internship grading policy; methods of grading internships may vary.

16. Some departments permit students to receive both credit and monetary compensation. Check with your department to determine that department’s policy.

17. Complete a Credit Internship Application prior to obtaining the required signatures. After obtaining the required signatures, take the application to the department awarding the credit for the internship. Students should retain a copy for their files of the signed internship agreement. Obtain your Add card from the sponsoring department. Credit Internship Applications must be submitted to the Chair/Associate Chair of the department awarding the internship credit no later than one week prior to the last day of Drop/Add.

18. Career Services is available to help students and faculty when appropriate in writing agreements that specify measurable learning objectives.

Questions should be directed to the Chair or Associate Chair of the department offering the internship credit.

International Students: You must have the internship approved by an International student advisor before your first day of work.

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PLEASE TYPE or PRINT all information except signatures. Instructions for downloading form
Student Information
Last Name
First Name:
Student Number:
E-mail:
Phone:
Address:
City/State/Zip:
Class Standing:	Sophomore Junior Senior
College/School:	Arts and Sciences
Major:
Current Cumulative GPA:	__________________

Employer Information
Employer Name:
Supervisor:
E-mail:
Phone:
Address:
City/State/Zip:
This application must be approved before you start your internship.
Internship Department:
Course Number:
Number of Credit Hours Requested:
Faculty Sponsor Name
Faculty Sponsor Department
Faculty Sponsor Telephone
Faculty Sponsor E-mail
Internship Information
Position Title:
Start Date:
End Date:
This internship is:	Unpaid Paid Salary per Hour:
Hours per Week:		Total Hours:
Position Description. Describe the nature of your position and/or your duties. What will be the most substantive aspects of your position? (How will you spend the majority of your time?)

Educational Objectives. What do you hope to learn from this experience?

Learning Activities. Describe the academic work that you will do (readings, research, data collection) and the academic work you will produce related to the internship (research paper, data analysis, creative/artistic work) to merit the awarding of the academic credit requested. Please be detailed in describing the nature and amount of academic work.

Self Evaluation. Describe how the internship experience relates to your major and career interests and how you will evaluate the learning experience. What evidence will you provide to document your accomplishments?

Work Supervisor Evaluation. How often will you be evaluated by your work supervisor?

Weekly Other ______________________

What will be the method of evaluation and how will these evaluations be documented?

Faculty Sponsor Evaluation (to be completed by the faculty sponsor). How will you (the faculty sponsor) evaluate the academic work completed in conjunction with this internship?

Responsibilities Under This Agreement

When signing this agreement, you agree to assume the responsibilities listed for your role.

I, the Internship student, agree to:

1. Perform to the best of my ability those tasks assigned by my supervisor which are related to my learning objectives and the responsibilities of this position.

2. Follow all the rules, regulations, and normal requirements of the employer’s organization.

3. Fulfill this Credit Internship Application under the direction of a faculty sponsor, and consult as needed with my faculty sponsor for guidance and evaluation when receiving academic credit.

4. Notify my faculty sponsor and the Chair/Associate Chair of the department awarding the internship credits of any changes I need to make in this agreement or of any problems that develop during the placement.

5. Complete an evaluation of the internship.

6. Complete the academic work described in this agreement and submit it to the faculty sponsor for review in a timely manner (no later than one month after the completion of the internship). I understand that credit for the internship will not be awarded until I have submitted the academic work as described and that work has been evaluated as satisfactory by the faculty sponsor.

I, the Employment Supervisor, agree to:

1. Provide the necessary orientation, training, precautionary safety instructions, and supervision in the performance of the position duties and responsibilities on this agreement.

2. Understand the responsibility for providing Workers’ Compensation and liability insurance in accordance with Colorado state law, and agree to provide said coverage if student is paid.

3. Complete a final written evaluation of the student’s performance during the placement and send it to the faculty sponsor listed on this application.

I, the Faculty Sponsor, agree to:

1. Attest that the proposed internship is relevant to the student’s area of interest, that, given the student’s proposed educational and career objectives, the experience is academically sound, and that the academic work proposed is relevant to the student’s major and is sufficient to merit the academic credit requested.

2. Agree to coordinate, monitor, and evaluate the internship as appropriate.

3. Agree to ensure that the academic work described in this agreement is completed and submitted in a timely manner and to review and certify that the academic work is appropriate before the credit requested for the internship is awarded.

4. Agree to ensure that the student is not being required to work more than the agreed upon hours a week.

According to C.R.S. 8-41-105(7)(a) & (b):

The employer is responsible for providing Workers’ Compensation and liability insurance coverage for those students receiving remuneration for a Cooperative Education or student internship work experience. In cases where the student is not receiving any remuneration for the work experience from the employer, the educational institution sponsoring the student is responsible for providing Workers’ Compensation.

The University of Colorado at Boulder encourages employers to extend Workers’ Compensation coverage to all students, whether paid or non-paid, since the employer can best control the safety of the work place and provide accordingly for the risks a student may incur.

The student, employer, and faculty sponsors agree to assume these responsibilities for the duration of the student’s placement. The Credit Internship Application must be completed in order for the academic department to endorse the student’s placement, for the placement to be considered “sponsored” by the University of Colorado at Boulder, and for the student to receive credit for the experience.
Please secure signatures in sequence. Your signature means that you have read and abide by this agreement.
1. Student		Signature: _________________________________ Date ________ Name printed or typed:
2. Work Supervisor		Signature: _________________________________ Date ________ Name printed or typed:
3. Faculty Sponsor		Signature: _________________________________ Date ________ Name printed or typed:
4. Chair or Associate Chair (of department awarding credit)		Signature: _________________________________ Date ________ Name printed or typed:
Internships for Credit: The faculty member’s and Chair’s or Associate Chair’s signatures are REQUIRED PRIOR to the start of your internship for placements carrying credit.
	If all the information is complete, print the application, obtain the necessary signatures, and submit to the department awarding the credit well in advance of beginning your internship experience. You will be registered for the internship credit by the department awarding the credit.

AAC 5/05