Internship Commitment Form

This is the faculty member who has agreed to supervise your internship experience.
You may complete this form only once so please verify that you have listed the correct faculty sponsor for your internship. Behavioral Sciences and Breech programs have a designated faculty sponsor.

This is your faculty advisor. Their approval is needed to register for credit.

*Discuss your academic assignments with your Faculty Sponsor before completing this section.

Please read the following information carefully and make sure you understand all the details of this agreement. Once you complete it electronically, a copy of the Internship Commitment Form along with the Agreement, Disclosure, and Certification will be emailed to you as a single, two page PDF document.

Drury University itself does not control the way in which the internship work experience and the internship site is structured or operates. In granting academic credit for this internship, the university affirms that, to the best of its judgement, the experience is an appropriate curricular option for students and worthy of Drury University credit. The university makes no other assurances, express or implied, about any travel and/or living arrangements the student has made. Drury University does not knowingly approve internship opportunities that pose undue risks to their participants. However, any internship or travel carries with it potential hazards which are beyond the control of the university and its agents or employees. In signing this Agreement, I acknowledge my responsibility to ascertain the nature of those risks to the best of my ability and to conduct myself with reasonable care.

I have sufficient domestic and/or international health, accident, disability, and hospitalization insurance to cover me during my internship and/or I further understand that I am responsible for the costs of such insurance and for the expenses not covered by insurance. I recognize that Drury University does not have an obligation to provide me with insurance coverage or reimbursement for medical care.

I understand that if I use my personal vehicle for the benefit of the organization/agency with whom I perform my internship that Drury University has no liability for personal injury or property damage which may result from that use.

I understand that I will not be entitled to unemployment compensation benefits upon completion of my internship. I understand that the internship work experience is not an offer of employment. Rather the experience is for educational purpose with a set termination date. I also understand that Drury University assumes no liability for personal injury that I may suffer in the course of my internship. I agree to be responsible for ascertaining whether the organization/agency sponsoring my internship provides any insurance coverage for me. I understand that the Sponsor is not required to provide monetary compensation for the time I spend at the Sponsor's place of business during the internship experience. I agree to be responsible for ascertaining whether the Sponsor will or will not provide monetary compensation. Drury University prohibits discrimination on the basis of disability, race, color, creed, gender, age, sexual orientation, national or ethnic origin, or veteran status. Drury University requires the Sponsor to affirm that the Sponsor also prohibits any and all discrimination.

I understand that the responsibilities and circumstances of an off-campus internship require a certain standard of professional decorum that may differ from that of Drury University and I indicate my willingness to conform to professional standards of the internship site. I further understand that it is important to the success of the present internship and the continuance of future internships that interns observe standards of conduct that would not compromise Drury University in the eyes of the individuals and organizations with which it has dealings. I acknowledge Career Planning & Development professional staff's responsibility for setting rules and interpreting conduct for this purpose. I agree that should Career Planning & Development professional staff decide that I must be terminated from my internship because of conduct that might bring the program into disrepute, or the internship into jeopardy, that decision will be final (subject to review by the Dean of the Students) and may result in loss of academic credit for the internship. If terminated from my internship, I also understand I will not receive a refund for the tuition and/or fees associated with the internship.

I understand that Drury University reserves the right to make cancellations, changes, or substitutions in cases of emergency or changed conditions or in the general interest of the internship program. I understand that Career Planning & Development professional staff may take any actions considered to be warranted under the circumstances and/or to guard the integrity of the internship program, including termination of the internship experience.

I further expressly agree that the internship site and its use of any facilities shall be undertaken by me at my sole risk and that Drury University shall not be liable for any and all claims, demands, injuries, damages, actions, or causes of actions, whatsoever to me or to my property arising out of or connected with the internship and with the use of any and all services or facilities associated with the internship, whether or not sponsored by Drury University. I release, discharge, and covenant not to sue Drury University, its governing board, employees, or agents as to any and all liability that may arise out of any injury or harm to me, death, or property damage resulting from my participation in this internship, excepting only liability due to the misconduct of Drury University.

I attest that I am over the age of 18 and may legally perform an internship in the United States of America, or, if applicable, internationally.

I warrant that I have disclosed all relevant, pertinent information that could affect my ability to successfully complete the internship.

If completing an internship internationally, I understand it is my responsibility to schedule a meeting with the International Programs Office prior to departing.

I understand and acknowledge that in the wake of the COVID-19 pandemic and other emergency issues, that there may be increased health hazards in the workplace and/or internship site than there would ordinarily be. I understand that I am responsible for investigating and making the ultimate determination as to whether said workplace and/or internship site is safe, and I am further responsible for using good judgment, and fully complying with all guidelines and orders from state, local, and federal authorities, along with any additional regulations that may be imposed by the employer. I will not engage in any actions that would expose others to risk in the course of my internship. I agree that should the Career Planning & Development professional staff decide that my internship cannot be continued due to a pandemic situation, that decision will be final (subject to review by the Office of the Provost) and may result in an alternate internship credit being assigned. If my internship takes place in an alternative format or with an alternative employer than originally intended due to COVID-19 or other pandemic or emergency events, I also understand I will not receive a discount or refund for the tuition and/or fees associated with the internship.

I understand that as a student participating in an internship that it is my responsibility to make sure I am in compliance with specialized trainings requested by the employer/organization that is employing me regardless of paid or unpaid position status. I understand that I am responsible for the cost(s) for any additional trainings or background checks required for my internship. Additionally, I acknowledge I have reviewed the information regarding HIPPA and FERPA provided by visiting the link below.