The Department of Kinesiology

Penn State University

The program involves _______________________ and the Department of Kinesiology at Penn State University for the mutual goal of training __________________ during an internship under the direction of a supervisor in the employ of the agency/institution identified above.

The internship is intended to provide the student with a culminating/integrating experience in a typical work setting that is appropriate for each student’s course of study and his/her short- and/or long-term career goals.

This program will commence on _____________________ and will terminate on _________________ unless terminated sooner by either party with 30 days’ written notice. It may be terminated immediately if conditions so require. Therefore, it is understood and agreed between the parties as follows:

RESPONSIBILITIES OF _____________________________:

1. If your site has not had a Penn State intern in the past, please provide the Department of Kinesiology with written materials explaining the purpose of your program, an overview of the programs available to internship students, a list of specific responsibilities to be assigned to the student, and the name of the person who will be assigned to supervise the student for the duration of the time agreed upon.

2. Confer with the student prior to the start of the internship to:

a. Describe the expectations of the business/agency

b. Assign specific responsibilities and an on-site supervisor

3. Monitor the student’s progress in fulfilling assigned responsibilities.

4. Evaluate the quality of the student’s on-site performance at the completion of the internship.

5. Assign to the student any unanticipated responsibilities that have educational merit or value.

6. Sign each weekly report written by the student to be mailed to the campus supervisor to attest to the validity of the report.


1. Inform the student that professional and general liability insurance are not provided by the University

If such insurance is required by the cooperating agency/institution, it must be obtained by the student or supplied by the agency.

2. Assign a campus supervisor to monitor the student’s progress through reports, a final written report, and periodic phone conferences.


Coordinator of the Option Date On-Site Supervisor Date

Department of Kinesiology

Administrator, Program Head Date Cooperating Agency Title Date

Authorized Signature

Dean’s Office--Authorized Approval Date Student’s Signature Date

College of Health and Human Development

At the beginning of the internship, please return a signed copy to: Clarence Stoner, Internship Coordinator

270 Recreation Bldg

University Park PA 16802