Learning Agreement

Note: All text blocks must be completed in order to submit this form. Please fill it out appropriately, as it will be used for official records. Please do not use semicolons. Your 8-digit Sage ID number can be found under Academics portion of Sage, under Undergraduate degree progress. 

PLEASE NOTE: ONCE YOU HIT THE 'SUBMIT' BUTTON, A COPY OF YOUR INFORMATION WILL AUTOMATICALLY BE SENT TO YOU AND YOUR SITE SUPERVISOR.

Student Information

First Name:
Last Name:
Class Year:
Sage ID Number:
Major(s):
Minor(s):
Brandeis email:
Mobile phone:

Organization's Information

Organization's name:
Industry / Career Field:
Address:
City:
Country (if other than US):
US State:
Zip or Postal code:
Web Site:
Supervisor's first name:
Supervisor's last name:
Phone:
Supervisor's email:
Start date (mm/dd/yy):
End date (mm/dd/yy):
Total # internship hours:
What compensation (including 'none') are you receiving?

Learning Goals and Objectives

The following set of goals and learning objectives developed by the student and the site supervisor are used as guidelines for determining whether the requirements of the internship have been met. Attach additional pages to this contract if necessary. Learning Goals and Objectives should be specific, measurable, and achievable and must fall into the following categories:
  • Skill development
  • Personal growth and development
  • Career development
Please see here for an example of a well-written set of Learning Goals. You can also reference the Transcript Notation criteria
Learning objectives (What do I intend to learn during this internship?):
Activities (How will this internship help me learn?):
Evaluation (How will I demonstrate that I learned it?):

Written Requirements

The student is required to submit the following materials in relation to his/her internship:
  • Learning Agreement (Before)
  • Letter of Invitation/Offer from internship site (Before)
  • Student Evaluation (After)
  • Supervisor Evaluation (After)

Acknowledgment

I understand that receiving Transcript Notation requires the successful completion of the following:
  • Submitting this Learning Agreement on-line
  • Submitting a Letter of Offer
  • An internship of at least 5 weeks and 100 hours
  • Submission of Student Final Evaluationn (before the end of the internship)
  • Submission of Supervisor Final Evaluation (before the end of the internship)
Failure to complete the requirements by all assigned deadlines will prevent me from receiving official Brandeis Transcript Notation.