Internship Forms

The following forms will be used in conjunction with RCPT 469: Pre-Internship to secure your internship. 

ONLY REQUIRED IF AGENCY IS NOT ON THE APPROVED AGENCY LISTS

• Agency Internship Survey
  

If an internship agency is not on the approved list, have them complete this form.

REQUIRED INTERNSHIP FORMS:

• Agency Contact Information [PDF]

After you have selected an internship agency, complete this fillable PDF and download into your RCPT 469 D2L shell. You will rename the file using the following format: Your Last Name_Contact_Information_Form (sample: Smith_Contact_Information_Form).

• Radford University Internship Agreement [PDF]

This is the official contract between the university and the internship agency.  It must be completed by the student first then passed on to the agency internship supervisor for signature. Once the student and internship supervisor have signed this agreement, it should be submitted to the student’s RCPT 469 D2L shell. The RCPT 469 professor will be responsible for obtaining the needed signatures from Radford University. Please rename the file as follows: Last name_RadfordUniversity_Internship_Agreement: (sample: Smith_RadfordUniversity_Internship_Agreement

• CEHD Affirmation and Acknowledgement of Risk [PDF]

The student must download this file and complete by hand. Be sure to initial and sign where appropriate. Please rename the file using the following format: Last name_CEHDAffirmationAcknowledgementofRisk (sample: Smith_CEHDAffirmationAcknowledgementofRisk

• ADDITIONAL FORMS 

The internship agency may require additional documentation (e.g., contracts requiring approval by the RU Procurement Office, screening tests, background checks, insurance documents, etc.). It is the student’s responsibility to obtain and complete any additional forms. Students enrolled in RCPT 469 should deposit copies of these forms in their D2L shell.