Student Practicum/Internship Agreement

Name

First

Last

Name of Your Faculty Advisor

Phone

Name of sponsoring agency or institution

Name and title of agency/organization supervisor and contact info, including phone and email

The agency or institution and its designated supervisor understand and agree that they are to:

Plan for and monitor the student's placement.

Orient the student to the overall operation of the organization or institution and its role in addressing social issues, needs and other kinds of ministry.

Designate a qualified person to supervise the student's time, activities and learning, and to evaluate the student's performance.

Introduce the student to appropriate staff and orient them to their tasks and roles, and make available learning opportunities relevant to the student's program and learning goals.

Provide adequate initial training/direction to the student so that they can proceed with appropriate independence.

Contact the Cherry Hill Seminary faculty supervisor should a problem arise with the student's Practicum/Internship performance.

Assist the faculty supervisor in assessing student performance by completing an evaluation form supplied.

Agree to hold Cherry Hill Seminary free from any liability that might be occurred by the student during the course of this placement.

Required signatures (this agreement will not be approved without the following)

Print a copy of this form after clicking "Submit" below.

Have the form signed AND dated by the sponsoring agency or institution supervisor.

Scan the signed form and email to your CHS faculty supervisor.

Student Practicum/Internship Agreement

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