19-060.00 Western Illinois University: Graduate Internship I9– 00 00
'Graduate Internship Agreement '
Between the City of Spokane Valley
and
The Board of Trustees of Western Minute University,on behalf of be Department of Recreation.Park and Tourism Administration
Macomb and Quad Gilles Campuses
This agreement confirms arrangements bra graduate level Internship placement for Derek Hoffman at City of Spokane Valley during to Summer
semester of 2010.The semester begkrs May 21,2010 end concludes July 2S,2010.Students must template a mWnum of 100 hours(ypSMy tree
months minimum at an average of 40 hours pet week)end remain b the Mercy brownout the duration of me sensor.
The✓nlwnIty agrees b:
• rotde the Agency with appropriate intormation about the student alinement,the Graduate Mtemsp Program,and the expece0wa for the
Internship nperier's*
provide the Student web an Internship guide lhet can be found In to RPTA Graduate Student Handbook that outlines the progression and
scope of the Winnable the polder and procedures forma,and records and reports 10 be submitted.
• place students ooly In agency ekes that meet the selection criteria
assign to the Agency only students who will have successyy completed to Menden prerequisites of the Graduate Internship Progrwn
provide•Faculty Internship Supervisor sdm MU motor the Memehp and consult regarding any problems the student or the Agency is
having with the internship
comply with al applicable state,federal,and btu IeWs regarding the confidentially of patient information and medical records
provide liability insurance coverage of$1,000.000 ler the student during performance of professional services M the praclkum
• solicit performance evaluation input from the Agency kid Instructor end assign the final grade
The Student agrees lo:
work the scheduled hours t the Agency and comply with the Agencye policies end procedures
comply with the University.polices and procedures
pediopete In Mannino the Internship and submit hl-weepy repode to Me Faaly Hemshp Supervisor
engage M midterm and final evaluation conference calls with the Faculty Inlenehp Supervisor
keep to Agency field instructor and the Faculty Internship Supervisor fully Informed about the Internship experience and the student's
supervision needs
rglste for six semester hours of credit RPTA 003
malntap health insurance coverage during to course ripe kiemefp
comply wilt M applicable federal,state and local laws regarding the confidentially of patient Information and medical records
The Agency agrees to:
designate an agency field Instructor with Me proper credentials end experience to supervise the student
allocate appropriate the ler student supeMsdn,including scheduled weekly supervisory sessions and oversight of any activities In Mich the
student Is arraigned to work with Mer professional Welt
allocate appropriate sine ler field Instructor ohptagon,consdsipn,end education provided by the Unvenky,Including potable vises by the
Graduate Internship Program Faculty Internship Supervisor when feasible
provide adequate work support for to student,Inducting office space.computer and telephone access,clerical support,and expenses for
business travel
provide appropdate orientation.work assignments.els learning experiences kr the student,including direct service to dents and
pelkpation M Agency end cwmmuNy meetings
comply with a0 applicable federal,slate,and local Inn regarding the confidentiality of patient information and medical records
assess the teaming and MB needs MIM student and submit midterm and final petulance evaluation toms
assist the student In self-assessment and M Integrating theoretical knowledge wth applied experience
keep the Faculty Internship Supervisor informed about the student's parlament.
keep to Faculty Interep Supervisor Informed about Agencpunlersly relationship issues
If applcable–NCTRC Certification 0 Date:
This agreement wed remain in effect until the student completes the field**offence a In the Agency.The agreement may be terminated by ether the
Agency or the Unyardy,kllowkg aowWMn Mid**the Agency,the student,and the University,when the successful completion of the graduals
Internship Is rete a given situation.
Board of T lands Uneasily
u'6'i /-= i
—
Wiliam Osler,Dk.of SComptencebate 4'T Gy ate Intents* 'If Dais
,n/ Pr Dais
. ,� H- .20/9
RPT admate Program •••• •' •.
City 3/A/..0 ,
Agency S 'am - Date RPTA Grad b Committee Chair Dale
/aft
Kilt _ ,F–Y ,et .,2,�/rte.,_.. / p;). _ ��)�i/
President Jack Thomas Dale t4'' Dr.Russell Morgan,Assoc Assoc Pry Dae
Ohl
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