AGNES SCOTT COLLEGE
Credit Internship/450 Course Application
The application must be completed by the student and approved by the intern sponsor, faculty sponsor and department chair.
The form must be submitted to the coordinator of internships (see next page for procedure and catalog for further information).
Name: ____________________________________________________________
Date: _______________________________
Class: ____________________________
ASC Box: ___________________
Cell Phone: __________________________
Major:
Email: _______________________________________________________________
INTERNSHIP Attach the description of your proposed internship (see procedures).
Semester of Internship Registration: __________________
Semester at Internship Site: _________________________________
Credit Hours: ___________________
_______________________________________________________
Place of Internship:
Address:___________________________________________________________________________________________________
Is this a paid internship? ____ Yes ____No
If yes, are you an International student? ____Yes ____No
If yes, please obtain approval from the Office of International Education:
International Education Signature: _________________________________________
Date: __________________________
INTERN SPONSOR
Name: __________________________________________
Position/Title: ____________________________________________
Company or Organization: ____________________________________________________________________________________
Email:
Telephone: _____________________________________________
I agree to supervise this student in the work described on Attachment B and to provide a final evaluation of the student’s work.
Signature: ______________________________________________________________
DEPARTMENTAL RECOMMENDATION
Date: __________________________
See sections III.7 and III.10 of the Faculty Handbook.
Faculty Sponsor: ________________________________________
Telephone: _____________________________________
Department: _______________________________________________________________________________________________
I recommend approval of this student’s placement and agree to monitor, evaluate and assign the final grade certifying the credit for this internship.
Faculty Sponsor’s Signature: _______________________________________________
Date: __________________________
Department Chair’s Signature: ______________________________________________
Date: __________________________
STUDENT
I agree to fulfill the assignments as described on the attached pages and understand what is required of me, the criteria that will be used for
evaluation and the nature of the grading. I understand that tuition, in addition to that charged for the academic year, will be charged for each 450
internship taken as a summer session course.
Student’s Signature: ______________________________________________________
Date: __________________________
APPROVAL
Coordinator of Internships: _________________________________________________
Date: ___________________________
Procedure for Credit Internship/450 Course Application
1. Meet with the coordinator of internships (Buttrick 302) to discuss the guidelines for academic
internships.
2. Review data provided by the Office of Career Planning or the coordinator of internships to determine
if an established internship in your area of interest is available. Internships may also be designed by
academic departments.
3. Students must consult with the faculty sponsor and intern sponsor to formulate the project and
complete Attachments A & B. At the first meeting with the intern sponsor, the student should give
her/him the sheet that describes her/his role as sponsor.
4. Students should submit Attachments A & B with the application. Students should be as specific and
complete as possible in describing the practical and academic components of the internship and the
methods that will be used to evaluate both academic and practical assignments.
5. Enter the number of credit hours on the application.
6. Faculty guidelines for determining the amount of credit are provided in the Faculty Handbook,
Section III. Note that current professional standards suggest for a full-time internship a student should
complete 35-40 hours at the internship site for each hour of credit. Students attempting 4 hours of
credit should spend a minimum of 8-10 hours per week at the intern site.
7. The proposal must be approved by the appropriate department or program and submitted to the
coordinator of internships no later than the end of the first week of classes. The application must
have all the appropriate signatures.
8. Approval by the coordinator of internships must be obtained before beginning the internship.
Approval will not be granted if the internship has already begun.
9. Tuition, in addition to that charged for the academic year, will be charged if credit is earned for a 450
internship taken as a course during a summer session. Year Five students will be charged full tuition
for each 450 internship.
10. With approval, a student may complete the practical component of an internship (Attachment B)
during the summer and complete the academic component (Attachment A) during the fall semester.
The 450 Course Application must be approved prior to the last day of classes in the spring
semester. The student will receive credit for the internship at the completion of the fall semester.
ASC Internship 450 December ‘11
450 Credit Internship Attachment A
(Complete with Faculty Sponsor)
Student Name:
Date: ____________________
(Attach a separate sheet if necessary)
LEARNING OBJECTIVES AND ACADEMIC ACTIVITIES
A. List learning objectives related to your academic program. Describe what you expect to accomplish in
relation to your program. Be Specific. Use measurable terms. Allow for the inclusion of personal
development objectives.
B. List academic assignments (include reading list and writing assignments) and schedule of meetings
with faculty including any planned faculty site visits.
Academic assignments should include critical journal reflections. Note: Reflections should provide
evidence that the experiences helped the student understand certain course material better, and/or
that certain course material helped the student understand the experiences better.
CRITERIA FOR EVALUATION
List the standards that must be met in order to receive a passing grade.
Example: “Student must attend all scheduled meetings, write A-level papers, complete a minimum of 130
hours at her internship site, and receive good evaluations from her internship sponsor.”
Credits to be awarded for internship: ________________________________________
Department
# of Credits
_________
Student’s Signature: _______________________________________________
Date: _________
Faculty Sponsor’s Signature: ________________________________________
Date: _________
ASC Internship 450 December ‘11
450 Credit Internship Attachment B
(Complete with Intern Sponsor)
Student Name:
Date: ____________________
Name of Internship Organization:
Address:
Telephone:
Name of Intern Sponsor:
Signature:
# of hours per week at site: _____ # of weeks: _____
(Attach a separate sheet if necessary)
JOB DESCRIPTION
A. Describe in as much detail as possible your role and responsibilities while on your internship. List the
duties, projects to be completed, deadlines, etc.
B. How will your internship activities relate to the academic objectives for your major?
SUPERVISION
A. Describe in as much detail as possible the supervision to be provided. What kind of instruction,
assistance, consultation, etc., you will receive from whom.
B. Discuss any potential risks or liabilities associated with work at this intern site. How will the site
minimize the stated liabilities/ risks?
EVALUATION
How will your work performance at the internship site be evaluated?
ASC Internship 450 December ‘11
AGNES SCOTT COLLEGE
Information Sheet for
Intern Sponsors of Credit Internships
Agnes Scott recognizes that learning through field experience can be a valuable adjunct to classroom
learning. The College will endeavor to make worthwhile experiences possible for students whose
academic programs would benefit from such opportunities. Field experiences should supplement, rather
than substitute for, the acquisition of academic knowledge; and the following information for off-campus
supervisors is offered to assist in understanding the nature of internships.
The best internships are those in which the student, the intern sponsor, and the faculty sponsor have
agreed on the nature of the work and understand the evaluation methods. This application, designed to
encourage this interaction, is a “contract” among the student, the intern sponsor, and the faculty sponsor
concerning the nature of the work assignment and the methods of evaluation.
The student is responsible for completing the application including Attachments A & B and obtaining
the required signatures. The completed application must be delivered to the coordinator of internships by
the appropriate due date.
Your assistance is important in the description of the internship assignment (Attachment B).
As a result of her discussions with you, the student should have completed these sections or should have
sought your assistance in order to complete them. The information should be as specific as possible,
although we understand that detailed information on potential work assignments is often impossible this
far in advance of the beginning of work. However, enough detail on the type of work should be provided
so that its appropriateness for credit in the proposed department can be judged.
Since credit for an internship is awarded by Agnes Scott College, the responsibility for assigning the
grade is with the faculty sponsor. The student will work with the faculty sponsor in completing the
Criteria for Evaluation section. Credit internships at Agnes Scott College are graded on a Pass/Fail
basis, with hours of credit requested at the time of application and approved by the dean of the college on
the basis of the faculty sponsor's evaluation at the end of the internship. The faculty sponsor may use
evaluation tools such as papers, daily journals, weekly meetings, and/or visits to the internship site.
Because the faculty sponsor will also need some evaluative information, you will be asked to evaluate the
student's performance.
Your supervision of the student is important, and we ask you to confirm this commitment on the
application form. This does not mean a constant “over the shoulder” commitment on your part, but rather
you should make sure that the student understands the assignments, is given proper preparation for them,
and is allowed to sample the nature of your organization. You become an “interpreter” of the student's
experience, but you do not have to be a full-time teacher. In fact, as part of her educational growth, the
student should have to use some initiative and, at times, work alone. We hope that you will also benefit
from the student's work and presence.
If you have any questions, please check with the student, her faculty sponsor, or my office.
Thank you for your assistance in this program.
David M. Williams
Coordinator of Internships
ASC Internship 450 December ‘11