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 experience. Learning Activities Discuss how you will accomplish your educational objectives. List projects, readings, meetings, presentation opportunities, etc. 2 CU-NIST PREP LOAA 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: 3 CU-NIST PREP LOAA 1. Perform to the best of my ability those tasks related to this position assigned by my NIST Advisor and CU Undergraduate PREP Advisor. 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 supervisor. 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. 4 CU-NIST PREP LOAA 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 continuance 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. 5 CU-NIST PREP LOAA 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 arise. 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 agreement. 6 CU-NIST PREP LOAA 1.________________________________________Date ___________ Undergraduate Scientist 2. ________________________________________Date ___________ NIST Advisor 3. ________________________________________Date ___________ CU Undergraduate PREP Advisor For Official Use Only: 4. ________________________________________Date ___________ Principal Investigator 7 CU-NIST PREP LOAA