Communication & Theatre Arts Internship Employer Acknowledgement and Agreement (ODU)

This form allows employers to approve of internship applications received by the Director of Senior Experience & Internships for the Department of Communication & Theatre Arts at Old Dominion University.

Please direct questions for the Communication & Theatre Arts Senior Experience or Internship program to Alison Lietzenmayer (alietzen@odu.edu) and general ODU internship questions to internship@odu.edu.

Internship Supervisor Name Internship Supervisor Name * First Last
Pronouns
Email *
Start/end dates (expected range of internship dates) *
Name of student intern you are approving for this opportunity and agree to supervise. *
Organizational Information

Please complete the internship provider information below.
Company name *
Is this a paid internship? *

Is this a paid internship? Yes No
Company Address Company Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Department in which student will be working *
Web Site *
Has your organization offered internships before to ODU students? *
Please share any questions for the internship director or Department of Communication & Theatre Arts here. Thank you!
Internship Supervisor Agreement
I agree to (check and complete): *

I agree to (check and complete): Provide adequate information and training for the intern including information about the organization’s mission, clientele and operational procedures. Provide adequate supervision to the intern and provide feedback on performance. Provide meaningful tasks related to education, skills, interests, and available time. Provide appreciation and recognition of the intern’s contribution. Verify and sign the intern’s time sheet at the end of the semester, which is required for the student to receive academic credit. Provide an evaluation of the intern’s performance to the internship instructor, which is required for the student to receive academic credit. I understand that if the student successfully completes all requirements of the course, in addition to the 150 hours of internship work, the student will receive 3 academic course credits.
Supervisor's electronic signature
Draw your signature into the box below. *

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.

Communication & Theatre Arts Internship Employer Acknowledgement and Agreement (ODU)

Communication & Theatre Arts Internship Employer Acknowledgement and Agreement (ODU)

Organizational Information

Internship Supervisor Agreement

Supervisor's electronic signature