NORTHAMPTON HIGH SCHOOL INTERNSHIP CONTRACT

Name_________________________________________________

Grade_______ Guidance Counselor_________________________ Date____________

Internship site/organization________________________________________________

Internship mentor________________________________________________________

Address________________________________________________________________

Phone #_________________________ Fax #__________________________________

Job Title: __________________________________________

Describe the internship on page 2 of this contract. Be as specific as possible. Include the
following information: 1. Objectives of the project 2. Activities to be undertaken
3. Requirements.
APPROVAL SIGNATURES:
STUDENT: I understand that this Internship constitutes a contract, is the equivalent
of a course, and that all of the obligation associated with a regular departmental course
apply to this agreement. I will hand in a time sheet each week and monthly evaluation
forms on the last day of each month. I will also write a reflection paper at the end of
the semester.

_______________________________________ ___________________________
Signature Date

GUIDANCE COUNSELOR: I have reviewed this student’s schedule for the

semester, and I agree that this internship is consistent with the requirements of
his/her overall program.

______________________________________ ____________________________
Signature Date

PARENT: I give permission for my daughter/son to pursue this internship, and, if

necessary, to leave school to accomplish the objectives.

______________________________________ ____________________________
Signature Date

MENTOR: I agree to reporting attendance to NHS weekly, evaluations of student

progress, providing appropriate tasks and direction for student success and
cooperating with the internship coordinator as needed.

______________________________________ ____________________________
Signature Date

PRINCIPAL’S APPROVAL ____________________________

 NHS INTERNSHIP CONTRACT – page 2

DESCRIBE THIS PROJECT IN DETAIL. BE AS SPECIFIC AS POSSIBLE.

Semester: Period/days:

Credits:

1. Objectives of the project:

2. Activities to be undertaken:

3. Requirements:
A. Weekly Time Sheets
B. Monthly Evaluations
C. Reflection Paper

• To receive a passing grade all of the above requirements must be

completed.
• Regular attendance requirements as per course catalogue are also
necessary for internships.

INTERNSHIP COORDINATOR: ______________________________ ________

date