On-Campus Academic Internship Registration | CalState S4

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Use this form to request academic internship postings for ON-CAMPUS DEPARTMENTS/OFFICES ONLY. Submitting this form does not guarantee approval. Please visit http://www.fullerton.edu/cice/partners/internships for information on criteria for Academic Internships at CSUF.

Proposed positions must include learning outcomes relevant to the course for which the student is seeking credit. Training must include direct mentorship from an expert within the internship job domain. Assigned tasks should provide the student with opportunities to demonstrate relevant learning outcomes; they should not be simply administrative or clerical in nature. Academic interns should not act as a supervisor or be responsible for managing other staff members.

For general information on academic internships, contact CICE at (657) 278-3746. For assistance on developing an academic internship, contact CICE Assistant Director, Robert Pierce, at rpierce@fulleton.edu.

IMPORTANT NOTE: If you are seeking to repost a position that has already been created for you in the past, please DO NOT COMPLETE THIS FORM and contact CICE at 657-278-3746 for assistance.

* Required

The student will perform all internship activities on the CSUF campus. *

If this position includes work activity away from the CSUF campus, please contact CICE at x3746 for further instructions on how to register the position. For liability reasons, this form is ONLY for internships in which the student will conduct all their internship activities on the CSUF campus (note: basic office activities, such as email or unsupervised word processing is exempt).

Yes

No

Internship Position Title *

Internship Term *

Fall

Summer

Spring

Other

Other: Please define term/period *

Are you posting this position for a particular student? *

If you received an email asking you to fill out this form from a student then this information should be contained in the email.

Yes

No

Student Name *

Student Email *

Would you like this position to be available for additional student to apply for? *

Yes

No

Supervisor Name *

Supervisor Title *

Make sure title reflects expertise in internship job domain.

Supervisor Email *

Supervisor Phone *

Supervisor Department *

Please enter the name of your office, program or department.

Office/Department Location *

Off-campus Locations *

Posting and Resume Receipt

Posting Start Date *

Date when this position is open for applications.

Month

Day

Year

Posting Expiration Date *

Date when this position is no longer open for applications.

Month

Day

Year

Method of Application Receipt *

Email

Website

Other

Application Email/URL/Other *

Required Documents

Résumé

Cover Letter

Transcript

Application Form (see upload option below)

Other

Other Required Documents *

Number of Openings *

Compensation Type *

Please choose the most appropriate descriptor. Please note that for any payment below minimum wage or that cannot be considered as taxable income (such as a scholarship) the position should be considered Unpaid.

Unpaid

Hourly

Other

Compensation Type Other *

Compensation Rate *

Position Description *

Provide a brief, overall description of the proposed internship position.

Note:

This info will be visible to students who are browsing Titan Connection.
If this is a RESERVED position, this information WILL NOT be visible to other students, but will be used only for review and approval purposes.

Learning Outcomes *

State 3-5 expected learning outcomes for the proposed internship.

"By the end of the internship, the student will be able to..."

Training *

Identify 3 to 5 specific training methods the supervisor will employ to help the student achieve the learning outcomes.

"To help the student achieve the proposed learning outcomes, I will..."

Tasks/Duties *

Provide a list of tasks/activities/duties that are intended to demonstrate the student's progress towards achieving the learning outcomes.

"The intern will demonstrate the learning outcomes by..."

Risk Management

Supervision Restrictions *

Students engaged in unpaid academic internships cannot be left alone for any amount of time with minors, elderly individuals or any other vulnerable populations.

Supervision must be provided at all times.

I affirm that CSUF students engaged in unpaid academic internship or service-learning positions will not be left alone for any amount of time with minors, elderly individuals or any other vulnerable populations.

Driving Restrictions *

CSUF students are permitted to drive as part of their duties for an academic internship experience provided they have completed all training and forms required.

As supervisor, you will ensure that any students asked to drive as part of their internship duties has been authorized appropriately by campus.

I acknowledge the driving policy stated above and will ensure all campus requirements are met prior assigning driving duties to the intern.

Will the intern be interacting with individuals who have a criminal background or a history of physical violence? *

Yes

No

Please describe the circumstances under which the interaction will take place. *

Please provide the following information:

1. Details concerning security at the site where interns will be working
2. Details of any training your staff have received to identify and respond to situations involving violent individuals or criminal behavior
3. Details of any training students will receive to identify and respond to situations involving violent individuals or criminal behavior
4. Procedures in place to mitigate danger to staff

Will the student be required to work with hazardous materials, heavy machinery or heavy equipment? *

Yes

No

Please provide details of safety measures, supervision and training *

Please provide the following information:

1. Details of any training students will receive to safely handle the materials or equipment
2. Details of standards that individuals interacting with this equipment or material are held to at your organization (eg. OSHA standards)
3. Details of protective equipment (if any) are required to be used by students on placement
4. Any other procedures in place to mitigate risk of injury

Will the supervisor of the student(s) be working at a different location from the student? *

Yes

No

Please provide details of how students work will be directed and how mentorship will be given. *

Is a background check required for this position? *

Yes

No