Academic Internship Partner Application

 
1 Start 2 Review & Submit

Academic Internship Application

Thank you for your interest in offering for-credit internship opportunities at California State Univeristy San Marcos.

This form will initiate the process for us to learn more about your organization and the internship opportunities that you’d like to make available to students. Ideally, a representative of the organization who is familiar with the learning activities that university students will be engaged in, as well as your safety policies and procedures should complete this form.

Note: CSU faculty or students cannot complete this form on behalf of an organization. 

General Partnership Criteria

The following general partnership criteria applies to all off-campus academic learning partnerships with the California State University (CSU). Additional program criteria may apply and is indicated in the program section. Please review the criteria and complete the acknowledgment statement.

  • Provide students with on-site orientation that includes, but is not limited to an overview of the organization's programs, policies, procedures and clients served; the service or work the student will be performing; site/placement expectations, including attire and professional conduct; specific training; and, information about any potential hazards or risks.
  • Provide student supervision.
  • Identify activities or work that may pose a health or safety risk. In the event that additional unforeseen risks become apparent, the organization must communicate in a timely manner all risk-related concerns to the CSU.
  • Your organization may be required by California law to obtain a student's fingerprints and submit them to the Department of Justice, and/or the Federal Bureau of Investigation, for a criminal background check. If required, the organization may have responsibility to:
    • determine whether such fingerprinting is required;
    • obtain the student's fingerprints;
    • obtain criminal background clearance from the appropriate agency; and,
    • incur the cost of fingerprinting.

To complete the remainder of the form, you will need to acknowledge the General Partnership Criteria by checking the box above. 

The group or groups of people with which your organization works, either directly or indirectly. If you're unsure, select "Non-specific/any population"
Provide your main address. Additional locations can be captured after when submitting new opportunities.
PLEASE NOTE: Home-based businesses may be approved once the required criteria are met but are rarely approved due to liability reasons. Furthermore, a site visit may be required but does not guarantee approval.
-
-
ext.
Opportunity Information

Below you can provide information for one (1) specific opportunity for our students. If you have more available, please provide details for the opportunity that is your highest priority. You may use our New Opportunity Form to submit additional opportunities.

Please provide information about the specific opportunity you have available for students enrolled at our institution.

Tip: Provide a detailed and comprehensive description to attract more applicants.
Start typing common words to search the list for related activities.
Please indicate the number of hours and duration a student would need to commit for this opportunity.
*THIS FIELD IS REQUIRED*

NOTE: An Academic Term is 16 weeks.
Hours*Duration*
Please select the term(s) that this opportunity is available.

A "term" corresponds with a semester on our campus Academic Calendar.

Example: They will need to use a personal vehicle to deliver supplies to a site.
Refer to US Department of Labor: https://www.dol.gov/agencies/whd/minimum-wage/state
Please provide compensation details
*THIS FIELD IS REQUIRED*

NOTE: For all forms of expense reimbursement, please provide more detailed information in the explanation box.
Type*Frequency*Amount*Explain OtherShow this to students?*
Please list step-by-step instructions for the student to apply.
Main Contact

The main contact information will be used by university faculty or staff members to contact your organization. CSU students will not have access to this information unless approved by the organization.

-
-
ext.
Legal Contact

The Legal Contact is the person at your agency or organization who has the authority to sign contracts with the university. We will send this agreement to the contact via AdobeSign. (Note: this information will only be available to campus staff executing contracts).

View draft agreement here: https://bit.ly/aidraftagreement

If this box is checked, unchecking it will clear all fields.
-
-
ext.
Site Supervisor Contact

The site supervisor contact typically acts as the on-site contact for students during their placement. This person may also be who students contact if they are interested in placing with your organization and/or who directly supervises students placed at your site. Indicate the type of staff contact this person is using the role selection below.

If this box is checked, unchecking it will clear all fields.
-
-
ext.
Contact Visibility

Organizations can show a designated contact to students.

Site Requirements

Please select mandatory site requirements below

Some requirements will incur cost; in the majority of cases, this will be the responsibility of your organization.
Site Safety Questions

This risk assessment is not intended to prohibit educational experiences that may seem “too risky,” but rather to find ways to reduce the amount of risk and liability exposure, so that the off-campus learning opportunity is a safe, healthful and fulfilling educational experience for all parties involved. This section should be completed by someone familiar with any potential risks.

You will be asked to provide additional information as needed based on your responses.
Please expand on the special or vulnerable populations the student will or may be working with and include information on whether the student will always be partnered with another staff, supervisor, or other trained professional when working with any of these special populations. If supervision is limited, please expand on additional safety protocols.
Briefly provide further information on the following as related to machinery/equipment/height risks (if applicable):

1. Please describe machinery/equipment/heights that may be used by intern

2. Safety training students will receive

3. Safety standards and protocols related to use of stated equipment (eg. OSHA standards, any organizational policies above and beyond OSHA requirements, etc.)

4. Required protective equipment (if any)

5. Any other procedures in place to mitigate risk of injury

Briefly provide further information on the following as related to chemical and/or biological hazards (if applicable) *NOTE: You do not need to list each individual chemical*:

1. Training students will receive to safely handle lab equipment, chemical and/or biologically derived materials

2. Safety standards and protocols related to the handling of chemical and biological materials (eg. OSHA standards, any organizational policies above and beyond OSHA requirements, etc.)

3. Required protective equipment (if any)

4. Any other procedures in place to mitigate risk of injury

Briefly provide further information as related to the physical safety of the location (if applicable):

1. Details concerning security at the site where interns will be working.

2. History of criminal activity in the area that you are aware of?

3. Details of parking facility security (is it secured and/or patrolled)?

4. Any additional safety information?

1. Will the intern be working alone at night (between 6pm and 8am)?

2. Approximately how much of the time (in a percentage) will the student be working without direct supervision?

3. Please provide details on how the interns work will be directed when a supervision is not in place?

Acknowledgement


Clear signature