Routing Instructions for 509 Internship form

Office of the Registrar

1)       Since internship applications originate at the departmental level, forms should be available at the departmental level. If a department does not have the 509 form, please contact the registrar’s office.

2)       The student completes 509 Internship Application with instructor and/or a department internship coordinator (according to department practice). A job description and syllabus with evaluation criteria should be attached unless these are kept on file in the college dean’s office.

3)       Students and departments should check the Internship web site  to see if an Affiliation Agreement exists for the agency involved in each internship. Confirming the affiliation agreement at this stage allows the student and department to assess whether there is adequate time available for processing of the application. The internship website can be reached through a link on the registrar’s web page or at http://departments.bloomu.edu/internship/. Click on the “Affiliation Agreements” link on the Internship website menu. Check the appropriate box (Yes or No) in Section II on the 509 form.

                                       i.      Please allow at least 4 weeks for processing of the application if an Affiliation Agreement is on file.  

                                      ii.      If no affiliation agreement exists, students should allow 8 to 12 weeks for final approval and should be cautioned that all approvals and registration are contingent on successful negotiation of an affiliation agreement.

                                    iii.      Under no circumstances should a student begin the internship prior to final approval and registration.

4)       Paperwork is sent to department chair for approval.

5)       Department chair sends paperwork to dean for approval.

6)       Dean’s  office confirms that an affiliation agreement exists for the specified site using the Internship Website.

a.        If an Affiliation Agreement exists:

                                       i.      Dean  approves, retains internship descriptive materials and forwards the 509 Internship Form to the Office of the Registrar.

                                      ii.      If no section of the appropriate internship exists on the Master Schedule of Classes a Master Schedule Change Form must be attached.

                                    iii.      Office of the Registrar creates a section of the internship course and enrolls the student.

b.        If an Affiliation Agreement does not exist:

                                       i.      Dean / Department submits a request for affiliation agreement to Elaine Parker in Office of the Registrar by sending copy of 509 Internship Form or by emailing all relevant site contact information.

                                      ii.      If there is no Affiliation Agreement, Deans holds 509 Internship form.

                                    iii.      Upon receipt of request from dean’s office, the Office of the Registrar will send out an Affiliation Agreement request to the agency and will send a confirmation of this action to Dean, Department, Instructor and Student via email and hard copy letter.

                                    iv.      If the agency does not respond within 30 days, a second request will be sent to the agency. This request will be copied to the Dean, Department, Instructor and Student via email and hard copy letter.

1.        When the signed agreement is received by the Office of the Registrar (All Affiliation Agreements must be signed by the Vice-President for Administration) a notice via email will be sent to Dean, Department, Instructor and Student.

2.        Dean approves, retains internship descriptive materials and forwards 509 Internship Form.

3.       If no section of the appropriate internship exists on the Master Schedule of Classes a Master Schedule Change Form must be attached.

4.       Office of the Registrar creates section of the internship course and enrolls the student.

Important note to Students

a.        Student completes SECTION I, items 1 – 12 in consultation with the faculty member who will serve as instructor for this course.

b.       Student HOLDS must be cleared before the internship credits will be scheduled.

c.        To verify acceptance student should check STINF.