University of Colorado Boulder

University of Colorado Boulder
Internships at the National Institute of Standards and Technology Learning
Objectives and Assessment Agreement
This agreement must be completed, signed and returned to Career Services in
order for the fellowship to be sponsored by the University of Colorado Boulder.
This sponsorship includes Workers' Compensation insurance coverage by the
University of Colorado. Completion of this agreement is also necessary to ensure
a high quality experience and satisfaction among all parties. Make sure that you
read the responsibilities under this agreement and print everything out.
Questions should be directed to Cat Wilson,
CU PREP Program Manager, at (303) 735-3535.
Student Information
Last Name: _______________________
Address: _____________________
First Name: _______________________
City: _________________________
Student ID Number: ________________ State: ________________________
Email: ____________________________
Zip: __________________________
Phone: ___________________________
Class Standing: ____________________
Major: ________________________
College/School: ____________________
Degree: _______________________
Work Information
Work Site: ________________________
Address: ______________________
Division/Lab: ______________________
City: __________________________
NIST Advisor: _____________________
State: _________________________
Advisor’s email: ____________________ Zip: ___________________________
Phone: ___________________________
Fellowship Information
This internship is:
Position Title: _____________________
Paid – Salary per hour:
Start Date: _______________________
Hours per Week: _______________
End Date: ________________________
Total Hours: ___________________
Position Description
List all duties related to this position.
Educational Objectives
List at least three concrete educational objectives you have for the PREP
Learning Activities
Discuss how you will accomplish your educational objectives.
List projects, readings, meetings, presentation opportunities, etc.
Self Evaluation
What mechanism(s) will you employ to evaluate progress on your objectives (lab
journal, verbal advisor feedback, written advisor feedback, self-evaluations, etc.):
Daily, Weekly, or By semester?
NIST Advisor Evaluation
How often will you be evaluated by your NIST Advisor?
By what methods (check all that apply):
Individual meetings
Group/lab meetings
Regular verbal evaluations
Regular written evaluations
Phone or other conferences
Responsibilities Under This Agreement
Each signatory agrees to assume the responsibilities listed for
designated role.
I, the Undergraduate Scientist, agree to:
1. Perform to the best of my ability those tasks related to this
position assigned by my NIST Advisor and CU Undergraduate PREP
2. Follow all the rules, regulations, and normal requirements of The
National Institute of Standards and Technology and The University of
Colorado at Boulder.
3. Consult with the CU Undergraduate PREP Advisor as needed for
guidance, and notify her of any changes I need to make in this
agreement or of any problems that develop during the placement.*
4. Provide CU Undergraduate PREP Advisor an evaluation each
semester, including the final semester at NIST, by the due date.
5. Work only the hours designated by my NIST Advisor, with the
understanding that working overtime (more than 40 hours in one
week) is grounds for termination.
6. Meet, at minimum, weekly with my NIST Advisor or other
I, the NIST Advisor, agree to:
1. Provide the necessary orientation, training, and precautionary
safety instruction the Undergraduate Scientist would reasonably need
to safely perform the duties and responsibilities of the position under
this contract.
2. Review mentoring guidelines with my NIST Undergraduate
Scientist and assist in completion of the Learning Objectives and
Assessment Agreement form.
3. Notify the CU Undergraduate PREP Advisor of changes to the work
schedule or this Agreement and report to both her and Cindy Kotary
of any problem, condition or occurrence that might place the
of a NIST-PREP undergraduate in jeopardy.
4. Work diligently to make the PREP Undergraduate Scientist’s
experience at NIST a successful one.
5. Review and approve the PREP Undergraduate Scientist’s self
evaluation each semester.
6. Prepare a Performance Review and Rating for the Undergraduate
Scientist by the appropriate due date each semester and meet with
the student in person individually to discuss the review.
7. Acknowledge and understand that NIST may claim only limited
rights in any invention or writing solely made by a PREP
Undergraduate Scientist that might result from the research
associated with this award.
I, the CU Undergraduate PREP Advisor, agree to:
1. Review the PREP Learning Objectives and Assessment Agreement
form with the Undergraduate Scientist.
2. Distribute and collect a self evaluation from the Undergraduate
Scientist each semester, including the final semester of work at NIST.
3. Meet with the Undergraduate Scientist, as needed, to answer any
questions about the experience.
4. Inform the Undergraduate Scientist of professional development or
other opportunities related to this position.
I, the Principal Investigator, agree to:
1. Act as a liaison between the Undergraduate Scientist, NIST, and the
CU Undergraduate PREP Advisor when necessary.
2. Assist the Undergraduate Scientist, CU Undergraduate PREP
Advisor and NIST in resolving any problems or difficulties which may
The Undergraduate Scientist, NIST Advisor, CU Undergraduate PREP
Advisor and Principal Investigator agree to assume these
responsibilities for the duration of the student's placement. The
Learning Objectives and Assessment Agreement must be completed
for the placement to be considered "sponsored" by the University of
Colorado Boulder.
Please secure signatures in sequence.
Your signature means that you have read and agreed to this
1.________________________________________Date ___________
Undergraduate Scientist
2. ________________________________________Date ___________
NIST Advisor
3. ________________________________________Date ___________
CU Undergraduate PREP Advisor
For Official Use Only:
4. ________________________________________Date ___________
Principal Investigator