Dallas County Community College District

INTERNSHIP/PRACTICUM/COOPERATIVE EDUCATION

Training Station Agreement

Program Information:

College _____________________________________   Year/Semester/Course ____________________________________

Rating Period ___________________________________    Year _______    Today’s Date  _____________

Major ______________________________________   Degree Plan Filed:          Yes _____         No _____

 


Student Information:

Name _______________________________________  Home Phone _______________________________

Email _______________________________________  Work Phone _______________________________

Student ID/SS# __________________________________       Job Title ______________________________________

Work Schedule

      Monday                  Tuesday                   Wednesday               Thursday                   Friday                Add’l Hours

 


Sponsoring Firm ________________________________________

Evaluating Supervisor ___________________________________     Email ___________________________

Title _______________________________________   Phone ______________________________________

Address ____________________________________  City/Zip _____________________________________

 

Training Agreement:

Three participants – student, supervisor and instructor/coordinator – in this Internship/Practicum/Cooperative Education venture will cooperate to determine the learning objectives toward which the student will work.  Each semester a student enrolls in Internship/Practicum/Cooperative Education, it is necessary that new learning objectives be identified.  Achievement of the objectives will be part of the basis for the credit and grade which will be earned for work experience.  The instructor/coordinator will visit with the student and the evaluating supervisor on the job site each semester.  The supervisor assists with the evaluation of the student performance. The instructor/coordinator determines the student’s final grade.  The student agrees to abide by the guidelines of the Internship/Practicum/Cooperative Education program.

____________________________________________

Evaluating Supervisor                                             Date

____________________________________________           _________________________________________

Educational opportunities are offered by the Dallas County Community College District without regard to race, color, age, national origin, religion sex, or disability.

 
 
Student                                                                    Date                              Instructor/Coordinator                                          Date