HTML Preview Business Administration Internship Agreement page number 1.
External Relations ~ Phone 803.323.2504 ~ Fax 803.323.2539 ~ www.winthrop.edu/cba
*Please contact Celeste Tiller, Director of External Relations for questions regarding the internship program: tillerc@winthrop.edu.
THE LANGUAGE IN THIS DOCUMENT DOES NOT CREATE AN EMPLOYMENT CONTRACT, EITHER EXPRESSED
OR IMPLIED, OR OTHERWISE ALTER THE AT-WILL EMPLOYMENT RELATIONSHIP BETWEEN ANY EMPLOYEE
AND WINTHROP UNIVERSITY. WINTHROP UNIVERSITY RESERVES THE RIGHT TO REVISE THE CONTENTS OF
THIS DOCUMENT, IN WHOLE OR IN PART, AS NECESSARY.
College of Business Administration-Internship Agreement
Winthrop University-213 Thurmond Building
STUDENT INFORMATION (To be completed by the Intern)
Today’s Date:_____________ Number of Credits:__ Credit(s)
Class Enrolled In:___________ Semester/Year Enrolled: _________
__________________________________________________ _____________________________ @winthrop.edu
Intern Name (Print Clearly) Email (Winthrop email will be primary method of communication)
_________________________ ______________________ ____________________________
Phone Number Student ID # Class/Graduation Year
_________________________ _____________________ ____________________________
Major Minor Concentration Faculty Liaison
Are you legally authorized to hold a paid off-campus internship in the U.S.? Yes ☐ No ☐
INTERNSHIP SITE INFORMATION (To be completed by Internship Supervisor) For Profit ☐ Not for Profit ☐
_________________________________________________ ___________________________ ____________________
Organization Name Business License # or FEIN # State Issued
(do not provide a SS#)
_________________________________________________ ___________________________________________________
Direct Internship Supervisor Supervisor’s Title
___________________________________________________________________________ Available for site visit? Yes ☐ No ☐
Physical Address
_________________________________________________ ____________________________________________________
Supervisor Phone Supervisor Email
Internship Projected Start Date: _________ Internship Projected End Date: __________
Est. Total Number of Weeks: ___________ Est. Total Hours/Week: ____________
Paid: Yes ☐ No ☐ If yes, $_______/________
Additional Compensation/Stipend: ________________________________________________________________________________
Internship site/supervisor accepts sole responsibility for determining the existence of an employment relationship as described by the
Fair Labor Standards Act (FLSA) Field Operations Handbook and for compliance with the FLSA and other state and federal wage-
related laws and regulations.
For Office use only:
Date Received ________ Correspondence sent to employer ☐ Correspondence sent to student ☐
Est. Mid-Point _________________
Other: _____________________________________________________________________________________________________