CBI Learning Contract

Must be completed by June 24th, 2022. For questions please contact Felicia Ford at Felicia.Ford@kzoo.edu

CBI Basic Information
Student Intern's Name * Required
First Last
Student Intern's K College Email * Required
Best phone number to reach the Student Intern this summer * Required
Supervisor's Name * Required
First Last
Supervisor's Email * Required
Organization Name * Required
Internship Start Date * Required
MM slash DD slash YYYY

Internship should last a minimum of 6 weeks and a maximum of 8 weeks. However, the time frame is flexible as long as it meets the minimum requirement of 240 hours in total.
Internship End Date * Required
MM slash DD slash YYYY

Internship should last a minimum of 6 weeks and a maximum of 8 weeks. However, the time frame is flexible as long as it meets the minimum requirement of 240 hours in total.
Number of Hours Per Week * Required
Please enter a number from 20 to 40.
The total number of hours for the internship should be between 240 – 280 hours.
Total Hours for Internship * Required
Please enter a number from 240 to 280.
The total number of hours for the internship should be between 240 – 280 hours.
Brief Description of Student's Duties * Required
Please share the expected frequency of student and supervisor meetings. * Required

Regularly scheduled meetings between the intern and supervisor are vital. These will ensure goals are met and the internship is a successful experience for all. We strongly recommend having weekly meetings.
Student and Supervisor Internship Expectations
This is for you and your supervisor to do together. We encourage you both to keep checking in with one another through the duration of the internship to ensure these goals are met.
What are the supervisor's expectations for the internship? * Required
What is the student intern hoping to learn this summer:
Hidden
Personally? * Required
Professionally? * Required
Civically? * Required
Disciplinary? (Related to your major or areas of study) * Required
Related to your (intended) major or area of study
Student and Supervisor Internship Goals
This is for the student and supervisor to do together. We encourage you both to keep checking in with one another through the duration of the internship to ensure these goals are met.
Student Goal #1 * Required
Please be specific!
Student Goal #2 * Required
Please be specific!
Supervisor Goal #1 * Required
Supervisor Goal #2 * Required
Mutual Student Intern and Supervisor Goal * Required
Electronic Signature from both Student and Supervisor
Student Intern's Consent * Required
I agree to statement below
By signing below, the Student Community Building Intern and Intern Supervisor both agree and commit to the specified expectations of each in this work experience, agree to support each other’s work goals and learning outcomes. They agree to sustain frequent student/supervisor meetings through the internship duration.

The student intern also agrees to be present at the weekly summer reflections hosted by the Center for Civic Engagement and complete reflection assignments as required.
TYPED Student Intern SIGNATURE * Required

This Acknowledgement and Certification of Understanding is to let you know that by submitting an electronic signature, you are providing an electronic mark, that is held to the same standard as a legally binding equivalent of a handwritten signature provided by you.
Date Signed * Required
MM slash DD slash YYYY
Supervisor's Consent * Required
I agree to the statement below.
By signing below, the Student Community Building Intern and Intern Supervisor both agree and commit to the specified expectations of each in this work experience, agree to support each other’s work goals and learning outcomes. They agree to sustain frequent student/supervisor meetings through the internship duration.
TYPED Supervisor SIGNATURE * Required

This Acknowledgement and Certification of Understanding is to let you know that by submitting an electronic signature, you are providing an electronic mark, that is held to the same standard as a legally binding equivalent of a handwritten signature provided by you.
Date Signed * Required
MM slash DD slash YYYY

Save and Continue Later

CBI Learning Contract

CBI Basic Information

Student and Supervisor Internship Expectations

What is the student intern hoping to learn this summer:

Student and Supervisor Internship Goals

Electronic Signature from both Student and Supervisor