Internship Forms

RPTA QUAD CITIES

For Students

Internship Manual PDF - The complete manual for internships, also the required text for RPTA 398.
Internship File Checklist PDF |Word - A complete list of all the paperwork required for your file before you may complete your internship.
Internship Overview of Assignments - PDF
Internship Scholarship - $500 Award given every Spring and every Summer/Fall session.
Appendix A - Interview Form PDF | Word - This form is used for the three agency interviews you will complete before choosing an internship site.
Appendix B - Site Information Sheet PDF | Word - This form should be completed about the organization you will be interning with.
Appendix C - Mid-term self-evaluation form PDF | Word - This form is completed when you are halfway through on your internship.
Appendix H - Sample Syllabus PDF
Appendix J - Presentation Rubric PDF
Appendix K - FLSA Fact Sheet PDF
Appendix L - Job Task Samples PDF
Weekly Report Forms PDF | Word - Weekly reports to be submitted to faculty supervisor during internship.

For Supervisors

Appendix D - Mid-term agency evaluation form PDF | Word - This form is completed by your site supervisor when you are halfway through on your internship.
Appendix E - Final Agency Evaluation Form PDF Word - This form is completed by your site supervisor when you finished with your internship. Please note: in addition to signing this form you will need to print your name before submission.
Appendix F - Site Supervisor Profile PDF Word - This form is completed by your site supervisor prior to beginning your internship. A resume will also be accepted in place of this form.
Appendix I - Internship Agreement Form PDF
Appendix K - FLSA Fact Sheet PDF

Internship Resources

Internship announcements will be posted to the bulletin board outside Currens 405.

A resource room is available at the Macomb Campus in Currens 405 and is open M- F 8am - 4:30pm.
Current and past intern postings, manuals, agency profiles and student reports are retained for reference.