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op student_agreement

Cooperative Education and Internship Program (CEIP)   College of Engineering 

Student Agreement Form

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Fill out the information requested below and, when done, click the "Submit Form" button. Use the tab key to move between fields. Note that the Enter Key will submit the form before it is completed.

Items marked * are required fields!

I understand the language in this agreement and I agree to abide by the following:

  * I understand that I must maintain a 2.750 grade-point average or I will be placed on probation and could be dismissed from the Cooperative Education and Internship Program.
  * I agree not to be employed during academic sessions where I enroll in 12 or more credits.
  * I agree to follow the 5-year Cooperative Education and Internship Program schedule that has been arranged by my Faculty Coordinator. Any deviation from this schedule should be in writing and approved by my Faculty Coordinator and the Director of the Cooperative Education and Internship Program.
  * I understand that while I'm out on a work term, I am still considered a full-time student and agree to pay the required work session fee to maintain my full-time status.
  * I understand that I must complete a minimum of three work sessions - two of which are non-summer work placements - to receive Cooperative Education and Internship Program certification upon graduation.
  * I understand that I am expected to remain with the same employer. I realize that I may be subjected to layoffs or could lose my position due to economic conditions beyond my control and the Cooperative Education and Internship Program staff will assist me in obtaining a new position.
  * I understand that I must obtain approval by my Faculty Coordinator to take a course during a full-time work session.
  * I understand that the faculty and staff of the Cooperative Education and Internship Program will offer guidance during my job search process and I agree to take responsibility for applying and interviewing for available experiential learning positions. The Cooperative Education and Internship Program Office cannot guarantee placements.
  * I agree to attend Cooperative Education and Internship Program seminars that prepare me for my practical learning experience.
  * I give the Cooperative Education and Internship Program Office permission to release my unofficial transcript upon request to a Cooperative Education and Internship Program company for possible employment.
  * I agree to notify the Cooperative Education and Internship Program Office when I receive an offer.
  * I understand that any requests for change in placement must be put in writing and reviewed by my Faculty Coordinator and the Director of the Cooperative Education and Internship Program.
  * I understand that if I accept a Cooperative Education and Internship Program offer for placement, I will not continue to seek employment for that same work session.
  * I agree to conduct myself in an ethical and professional manner in all my interactions with the Cooperative Education and Internships Office staff and all employers.
  * I agree to give the employer my total commitment for the time period that is assigned to me.
  * I agree to enter and maintain relevant personal information on the PlacePro Student module. This includes creating a resume, viewing job referrals and completing online evaluations.
  * I agree to complete in a timely fashion all Cooperative Education and Internship Program work term requirements including the Program Learning Agreement, Program Evaluations and Work Report for each work session.
  * I agree to complete my degree prior to accepting permanent employment with my employer.
  * I understand that failure to abide by this Student Agreement could result in dismissal from the Cooperative Education and Internship Program.

Last Name   *
First/Middle Name   *   (First Middle)
Student Identification Number   *   (NOT your SSN)
School Email  @umassd.edu  *
Major
Coordinator Last Name   *
Coordinator First/Middle Name   *   (First Middle)
I understand that under the Family Rights and Privacy Act of 1974, I have the right to inspect and review any records that are sent out of the University directly related to me. I hereby waive these rights regarding my resume, records, grades, or evaluations which:
(1) may be provided to an employer as the basis for my application for Coop/Internship employment;
(2) may be provided to or received from my Coop/Internship employer for the purpose of evaluating my progress while in the Coop/Internship Program.
Signature   (Please Initial Here)   *
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