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Family Studies and Human Development Internship Application Instructions  Read the Internship Application Packet thoroughly.  Make an appointment to see your academic advisor. o Together, you will consider whether you are ready for the experience, explore placement ideas, and get answers to your questions before you proceed with the placement search and application process.  Complete agency search and selection. You are responsible for arranging your internship placement. The Internship Coordinator can help you in the selection process.  Complete application and submit to the Internship Coordinator. Once you have agreed upon your placement site with your agency supervisor, you must complete and submit the following forms from this packet: o Internship Application (all 8 pages), please note that this application requires internship site signatures. o To-Date copy of your SAPR or DARS This process must be completed by the following dates: Semester to Enroll Fall Spring Summer

Applications Due First Monday in August Last Day of Fall Semester Last Day of Spring Semester

The Internship Coordinator will review your application. If approved, your information will be sent to the FSHD office for registration. If changes are needed, the Internship Coordinator will contact you to discuss the matter. It is important that you confirm your registration status by checking Student Link. Service Learning Program PO Box 210078 Tucson, AZ 85721-0078 Phone: (520) 621-7138 Fax: (520) 621-9445 Email:

Are You Ready to do an Internship?  I would like to apply what I am learning beyond what is possible in the classroom.  I am anxious to get out into the "real world" and work with people.  I have taken courses relevant to my career interests.  I may not know exactly what I want to do as a career, but I have a good idea and would like to get some experience.  It would be possible to adjust my courses for next semester so that I would have at least 10 hours of time per week to work off campus.  I would consider working without pay.  I feel confident that I have knowledge and skills that I can contribute to the community.  My grades are solid, and I feel I can spend time away from school without jeopardizing my GPA.  I have time to interview with several community agencies to find the right placement for me. If you answered "yes" to most or all of these questions, you may be ready for an internship. Otherwise, you should consider planning for another semester. Talk with your academic advisor to help you determine when would be a good time for your internship. You can receive more information on the Family Studies website: Eligibility for an internship is based on the following qualifications: 1. Be a declared FSHD major or minor. 2. Be in good academic standing with the University of Arizona and have maintained at least a 2.25 grade point average (major and cumulative) at the University of Arizona prior to applying for an internship. 3. Have junior or senior status with completion of the following courses: FSHD 117, 237, and two additional FSHD courses. 4. Transfer students should have completed at least one full-time semester—a minimum of 12 University credits.

Facts about internship… The internship experience is a bridge between your classes at the UA and your postcollege life. The approach is therefore not merely academic but dynamic and integral. This is a structured internship providing supervised practical experience at various agencies. This is an opportunity for students to work in a professional setting serving the needs of individuals and families. This internship is designed to integrate theory, research, and practice into a “real-world experience.” This internship is designed to increase student marketability and placement in the job market. Participants are FSHD majors and minors considering careers in counseling, teaching, social services, family law, and related areas. Interns earn university credit for working at their placement organization and completing academic coursework that is rooted in the service learning principles of reflection, demonstration, and reciprocity. Students are encouraged to think critically about social issues in the context of their field experience. Students may complete 1-2 semesters at the same internship site. Students may enroll for 2-6 units in fall, spring, or summer semesters. Interns are expected to work a total of 45 hours per 1 university unit. The table below lists the required work hours based on your enrollment.

Enrolled Units 2 3 4 5 6

Required Semester Hours 90 135 180 225 270

Hours per Week (based on 15 weeks) 6 9 12 15 18

Interns will be expected to:  Work at their placement organization each week on a schedule to be arranged with the site supervisor  Complete course assignments as outlined in the course syllabus

Internship Application Family Studies and Human Development Internship Program PO Box 210078 Tucson, AZ 85721-0078 Phone: (520) 621-7138 Fax: (520) 621-9445 Internship Coordinator Email:

Student Contact Information Name: Student ID#: Mailing/Local Address: Street



Zip Code



Zip Code

Permanent Address: Street


Expected Date of Graduation:

Minor: Home Phone:

Cellular Phone/Pager:

UA Email Address:

Emergency contact name, phone number, and relationship:

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Organization/Supervisor Contact Information Organization Name:

Mailing Address: Street



Zip Code

Supervisor Name:

Supervisor Title:


Business Phone:


Email Address:

Organization Website:

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Information About Your Internship Briefly describe the role that you will take in the placement site. What will be your job responsibilities and activities?

Have you worked at this site before? Please explain what you did, when, and whether you received university credit.

Will you be receiving monetary compensation for your work with this site? If yes, please explain.

*Please attach brochures and other information about the organization.

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University-Student-Organization Agreement Semester to Enroll:

Number of internship units: _______________

This internship is scheduled to begin________________ and terminate ___________. Date Date Approximate # of hours to be worked each week: ____________ (3 units=9 hours per week; 6 units=18 hours per week, etc.) The Intern agrees to the following: 1. Apply by the last day of the semester prior to participation. Students must complete this form and obtain all signatures prior to submitting the Internship Application packet. 2. Pay all registration fees associated with the credits to be earned. You may also be required to pay a fee to participate at the internship site for a criminal background check, training materials, or immunizations. 3. Discuss with your prospective supervisor at the work site the possible risks and dangers associated with the internship. 4. Complete all academic assignments and reporting requirements of the internship as specified by the internship instructor. 5. Recognize that you are representing The University of Arizona and The Institute for Children, Youth & Families in the community and abide by the Student Code of Conduct and Code of Academic Integrity. 6. Understand and follow the policies, procedures, and regulations of the internship site. 7. Be prepared to perform your internship duties for the hours and duration specified. Talk with the supervisor in advance about any University or religious holidays. The Family Studies and Human Development Service Learning program agrees to the following: 1. Select students who are in good academic standing, and who meet the eligibility criteria. 2. Ensure that students are not awarded internship credit for their ongoing job. 3. Complete and keep on file documents pertaining to this internship. 4. Act as a support and liaison for students and partner organizations during the internship. 5. Address the kind and amount of compensation (if any) that the department permits for internship credit. 6. Send to the internship supervisor evaluation forms for completion, and specify the deadline for these forms to be returned to the course instructor. The Sponsoring Organization agrees to the following: 1. Provide a description of the responsibilities and activities that the intern is expected to complete. 2. Make individual arrangements, if agreed upon between the student and organization, for any wage, stipend, or other benefit of service deemed appropriate. 3. Provide pertinent policies and procedures to students prior to the start of the internship. 4. Provide relevant education and training for the student intern. 5. Supervise and evaluate the intern’s performance regularly throughout the internship. 6. Notify the instructor of any decision to remove the student from an internship prior to the agreed upon time, and provide a written report to the department stating the reasons for the intern’s termination. 7. Complete and submit the Intern Evaluation forms & return them to the course instructor.

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CONDITIONS OF AGREEMENT The Department and Sponsoring Organization, in finalizing this agreement, shall make no distinctions or discriminate against any applicant for internship credit on the basis of sex, race, creed, national origin, age, or handicap. In consideration of the opportunity to participate in this internship, the undersigned Student and Sponsoring Organization do for themselves, their heirs, administrators and assigns, hereby release, discharge, and indemnify the University of Arizona, the College of Agriculture and Life Sciences, the School of Family and Consumer Sciences, its representatives, administrators, employees, and students from any and all liabilities, losses, damages, claims, fines, suits or actions of any kind and nature, resulting from or arising out of any actions, omissions, or negligence of the performance of this agreement. Furthermore, the Sponsoring Organization will provide the student intern with safety procedures and information as is customarily provided regular employees of the Sponsoring Organization. INFORMED LIABILITY STATEMENT I understand that The University of Arizona and its representatives have arranged to establish an internship position with the Sponsoring Organization, which complies with academic, and employment regulations, policies, and procedures of The University of Arizona. The daily managerial control and working conditions of the internship are under the sole discretion of the Sponsoring Organization and its designated agents. Consequently, I understand that The University of Arizona, College of Agriculture and Life Sciences, the School of Family and Consumer Sciences, its deans, directors, administrators, and employees, do not assume and cannot assume any liabilities, losses, or damages to me or others resulting from or connection with acts, judgments, omissions, or negligence occurring during my work for and with the direction of the Sponsoring Organization or its agents. In consideration of this, I have been informed of the importance of securing employer benefits or making my own arrangements for personal and professional liability. This agreement can be terminated at any time by mutual consent of the Sponsoring Organization, course instructor, and the student. I have read and understand this document. I agree to the terms of the internship experience as it is described above.

Organization Supervisor


Student's Signature


Service Learning Coordinator


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University of Arizona Internship ASSUMPTION OF RISK AND RELEASE FORM THIS IS A RELEASE OF LEGAL RIGHTS -- READ AND UNDERSTAND BEFORE SIGNING (If student is under 18 years of age, a parent or legal guardian must also read and sign this form)

Student Participant: Student ID: Sponsoring Organization: Internship Course: I hereby agree as follows: RISKS OF PARTICIPATION

I recognize that there are dangers and risks to which I may be exposed by participating in this internship. The following is a description and examples of specific, significant, non-obvious dangers and risks associated with the internship, as explained by the on-site supervisor:

I understand that the University of Arizona (the “University”) does not require me to participate in the internship, but I want to do so, despite the possible dangers and risks and despite this Release. I therefore agree to assume all of the risks and responsibilities that are in any way associated with the internship. HEALTH & SAFETY I understand and agree that the University and its governing board, administrators, and employees (the “Releasees”) do not have medical personnel available at the Sponsoring Organization, which is the site location for my internship. I understand and agree that the Releasees are granted permission to authorize emergency medical treatment, if necessary, and that such action by the Releasees shall be subject to the terms of this Agreement. I understand and agree that the Releasees assume no responsibility for any injury, damage or cost which might arise out of or in connection with such authorized emergency medical treatment. I have consulted with a medical doctor with regard to my personal medical needs. There are no health-related reasons or problems that preclude or restrict my participation in this internship. I

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have arranged, through medical insurance or otherwise, to meet any and all needs for payment of medical costs while I participate in the internship. I understand that neither the Releasees nor the Sponsoring Organization are obligated to provide transportation in connection with the internship. I understand that I am expected to carry my own automobile liability insurance coverage. STANDARDS OF CONDUCT I will comply with the University's Student Code of Conduct and Code of Academic Integrity, as well as the standards of conduct for employees of the Sponsoring Organization. I waive and release all claims against the University that arise at a time when I am not under the direct supervision of the University or that are caused by my failure to remain under such supervision or to comply with such codes and academic standards. I agree that the University has the right to enforce the standards of conduct described at: and that the University will impose sanctions, up to and including expulsion from the internship or from the University, for violating these standards or for any behavior detrimental to or incompatible with the interest, harmony, and welfare of the University, the department’s internship program, the Sponsoring Organization, or other student participants. The University has the right to make changes in the format and administration of the internship. I understand that the University has no control over the operations or premises of the Sponsoring Organization, and that I will be under the supervision of a representative of that organization while I am participating at the internship. ASSUMPTION OF RISK AND RELEASE OF CLAIMS Knowing the risks described above, and in consideration of being permitted to participate in the internship, I agree, on behalf of my family, heirs, and personal representative(s), to assume all the risks and responsibilities surrounding my participation in the internship. To the maximum extent permitted by law, I release and indemnify the Releasees from and against any present or future claim, loss or liability for injury to person or property which I may suffer, or for which I may be liable to any other person, during my participation in the internship (including periods in transit). I have carefully read this Release Form before signing it. No representations, statements, or inducements, oral or written, apart from the foregoing written statement, have been made. This agreement shall become effective only upon receipt by the University of Arizona in the Division of Family and Consumer Sciences, and shall be governed by the laws of the state of Arizona, which shall be the forum for any lawsuits filed under or incident to this agreement or to the internship.

Signature of Student Participant


Signature of Parent/Guardian (if student is under age 18)


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Family Studies and Human Development Service Learning Programs Internship Registration Form Form Instructions 1. Submit completed form to the Service Learning Coordinator with your internship application. 2. Once your internship is approved, this form will be forwarded to the FSHD office, and you will be registered. Check your registration status on Student Link before the semester begins.

Full Name:

Student ID#

UA Email Address: Major:


Class standing (jr,sr):

Expected Date of Graduation:

# Internship Credits Requested:

Semester to be Enrolled:

I have talked with my advisor and understand how these internship credits will be used in my curriculum.

Student Signature :Remember to attach your SAPR or DARS


Advisor Signature


Service Learning Coordinator use only: Please register this student for ________ units of FSHD ______ for

Service Learning Coordinator



FSHD use only: Registration completed:

by Date


Registration not completed due to Reason

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Next Steps—After You’ve Been Placed Once you have chosen your internship site and submitted your application packet to the Internship Coordinator, there will be tasks that you must complete before beginning work at your site. Your site supervisor should tell you what you need to do, but you should ask to make sure things go smoothly. Following are some common things you may be expected to do. 

Agency paperwork. You may need to complete a volunteer or employment application, or fill out other human resources forms before you can begin work.

Fingerprinting and criminal background check. If you will be working with children, or working closely with clients, you will be expected to go through a criminal background check. This typically involves fingerprinting and signing some legal forms. The background check can take from three weeks to three months. Because many organizations must receive the results of the check before allowing you to begin work, you should complete this step as soon as possible. You may be required to pay a fee for this process.

Volunteer training. Many organizations require a structured volunteer training, while others may train you individually or on the job. The training may not be offered at a time that coincides with the semester schedule, meaning that you may have to complete the training during the preceding semester, or during winter or summer break. You are responsible for completing all training as required by the placement organization.

Setting up your work schedule. You are responsible for setting your work schedule with your site supervisor. Most agencies are flexible, and are willing to work with your school schedule. However, the things you are most interested in doing might occur when you are scheduled to be in class. Check these out with your supervisor. Please be as flexible as you can to accommodate the organization’s needs as well.

Beginning the Semester Shortly before the semester begins, you will be contacted by email regarding course meetings and assignments. Please contact the Internship Coordinator with any questions. Congratulations! You’re on your way to a great semester!