Learning Contract

	Learning Contract Human Services Program Field Studies Forms.HSPFieldStudies@wwu.edu	#New Form

Learning Contract

Intern's Last Name:

First Name:

W#:

Email:

Phone:

Agency Name:

Agency Address:

Field Supervisor Name:

Supervisor Email:

Supervisor Phone:

University Instructor Name:

Academic Quarter:

Year:

Please use as much space as needed on the following page(s) to articulate your Learning Objectives and Learning Activities. Retain a copy of this Learning Contract for your records, and supply your Instructor and field supervisor with a completed and signed copy

Learning Objective 1: (Learning objectives describe what the student plans to know or do after completing
the quarter at the internship site.)

Corresponding Learning Activities: (Learning activities describe specific tasks that outline how the
student will accomplish the learning in the objectives.)

Learning Objective 2:

Corresponding Learning Activities:

Additional Learning Objectives and Learning Activities (Optional).

The following signatures indicate that these individuals have approved these learning objectives and their corresponding learning activities as an appropriate academic learning experience.

Student Signature:

Date:

Field Supervisor Signature:

Date:

University Instructor Signature:

Date:

Routing Instructions

	Student submits form link to the external intership site supervisor (students should send an email to their external internship site supervisor with the form link and any applicable info that their external site supervisor will need in regards to the form - e.g. if it is the Learning Contract, Form 5, students should include their Learning Objectives in their email with the form 5 link...if it is the Weekly Internship Schedule, Form 6, students should include the agreed-upon schedule in their email with the form 6 link)
	The EXTERNAL site supervisor initiates the form and enters their information (e.g., name/contact info, etc.), and submits it to the student's WWU Email.
	The Requestor (Student) fills in any needed information and once complete submits the form to Forms.HSPFieldStudies@wwu.edu
	FORMS (Field Studies) submits the form to the appropriate faculty
	The faculty signs the form and sends it to Forms.HSPFieldStudies@wwu.edu
	FORMS (Field Studies) can LOCK form at end of the quarter

Signatures and Attachments

The submitter may optionally enter their email address below. Press SUBMIT to send it.

Your Email Address: