INTERNSHIP AGREEMENT FORM
Department of Communication Arts & Sciences
The Pennsylvania State University

 

Intern's Name _____________________________________________________

Email ___________________________________________________________

Address _________________________________________________________

________________________________________________________________

Phone Number ____________________________________________________

Major _________________________ Minor ___________________________

Organizational Sponsor ______________________________________________

Address _________________________________________________________

________________________________________________________________

Immediate Supervisor ______________________________________________

Title ___________________________________________________________

Email ___________________________________________________________

Phone Number ___________________________________________________

Internship Position (Job Title) ________________________________________

Work Schedule ____________________________________________________

Inclusive Dates ___________________________________________________

Enrolled in CAS 495 _________________ Semester ______________ Year

Number of Credits _________________________________________________

Required Academic Assignments:

The following section is to be completed by the intern, in consultation with academic and organizational sponsors.

OBJECTIVES:
What are the goals/objectives of your internship experience?

JOB DESCRIPTION:
A brief description of the duties and responsibilities you expect the internship to entail.

SIGNATURES:

Intern (signature) _____________________________________ Date ________

Name (type or print) _______________________________________________

Organizational Sponsor (signature) _______________________ Date ________

Name (type or print) _______________________________________________

Internship coordinator (signature) ________________________ Date ________

Name (type or print) _______________________________________________

 

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