FINAL – JULY 1, 2010
FINAL – JULY 1, 2010
THE SAN DIEGO/IMPERIAL COUNTY COMMUNITY COLLEGE
ASSOCIATION (SDICCCA) REGIONAL FACULTY INTERNSHIP
PROGRAM:
A partnership between San Diego State University
and the San Diego/Imperial County Community College Association
PROGRAM HANDBOOK
FINAL, July 1, 2010
FINAL – JULY 1, 2010
TABLE OF CONTENTS
PROGRAM OVERVIEW:
Summary
SDSU Coordinator Welcome
Frequently Asked Questions (FAQ)
PROGRAM GOALS AND STRUCTURE:
Program Goals
Program Intern Learning Outcomes
Value to the Mentor and the Community College
PROGRAM ELEMENTS:
A specific intern learning plan
Sample Plan
Three Continuing Education Courses
Summer Institute and Friday-Afternoon Workshops
Schedule: 2010-2011
SELECTION PROCESS:
Intern Eligibility
Selection of Interns
Selection of Mentors
RESPONSIBILITIES:
Interns
Mentors
Campus Coordinators
Community College Support
SDSU Program Coordinator
PROGRAM HISTORY
Program Authorization
PROGRAM FORMS
Unpaid Service Learning Agreement
Intern Application
Intern Program Agreement Form
Mentor Program Agreement Form
Internship Learning Agreement
Learning Log
Friday Workshop Evaluation Form
Intern Program Evaluation Form
Mentor Program Evaluation Form
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PROGRAM OVERVIEW
SUMMARY:
The regional faculty internship program is a major cooperative initiative between the San
Diego/Imperial County Community College Association (SDICCCA) and San Diego
State University (SDSU). The purpose of the program is to identify, recruit, train, and
support prospective community college counseling and classroom faculty in their pursuit
of part-time and full-time faculty positions within community colleges in the region. The
partnership includes the ten community colleges in San Diego and Imperial County and
Mt. San Jacinto College in Riverside County.
The San Diego/Imperial County Community College Association (SDICCCA) was
formed in 1963 as a model of cooperation among public institutions of higher education.
The aim of this organization is to identify issues of concern and implement mutually
beneficial programs and projects in the region. The support of the SDICCCA Presidents
has been invaluable in contributing to the success of this internship program.
This program is managed by a Steering Committee comprised of a campus coordinator
from each of the participating colleges. A San Diego State University Program
Coordinator leads the Steering Committee, oversees group training sessions for interns,
and works with both the mentors and interns to confirm a positive learning experience
takes place for each intern. The Steering Committee provides input to the Program
Coordinator on the content of each of learning experiences and the processes for selecting
interns.
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SDSU COORDINATOR WELCOME!
Thank you for your interest in the SDICCCA Faculty Internship Program! This program
began in 1994 and has dramatically increased the number of well-trained new community
college counseling and classroom faculty.
Each participating community college designates a campus coordinator who recruits
mentors and participates in the match of intern\ applicants to mentor volunteers. Each
campus coordinator works with campus leaders to organize a 4-hour Friday afternoon
workshop on their campus focusing on a topic consistent with the curriculum of the
program.
Each intern, mentor, and coordinator has the privilege to shape the future of community
college higher education through participation in this program. Interns will expand their
knowledge of teaching/counseling techniques to enhance students‘ abilities to succeed
personally and academically.
Mentors and interns work together to develop a learning agreement for the year that
provides the intern with rich learning experiences about counseling and classroom
teaching and the mentor with a supportive prospective colleague. Sometimes interns play
an observational role; other times, interns assist in the development of assessment tools,
interactive activities, mini-lectures, and on-line assignments. Interns are expected to
constantly look, listen, reflect, and enjoy the experience of being immersed in the
community college experience. Because only about one-third of the applicant pool each
year is selected for the internship program, interns have a responsibility to do their very
best.
My special thanks to the past participants of the program including the Steering
Committee, Campus Coordinators, mentors, and interns—I greatly appreciate your
willingness to invest your time and talents into this important program. We are fortunate
to have the opportunity to be part of a nationally recognized program that has served as a
model for other community colleges across the country. I look forward to working with
you this year and in the future.
Sincerely,
Kendra
Kendra Jeffcoat, Ph.D.
Assistant Professor, SDSU, Office phone: 619 594-3570
Program Coordinator, Regional Faculty Internship Program
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FREQUENTLY ASKED QUESTIONS (FAQs):
What is the SDICCCA Faculty Internship Program? A one-year internship program for
prospective part-time and full-time community college counseling and classroom faculty
members
Why was it developed? To enhance the knowledge, skills, and abilities of prospective
community college counselors and classroom faculty members and to identify and recruit
prospective faculty who have diverse backgrounds, perspectives, and abilities to
contribute to the community college.
Why should I participate? Interns have the opportunity to work with a mentor to
negotiate a year-long learning experience to enhance their understanding of and ability to
serve as a skilled counseling or classroom community college faculty member. Mentors
have the privilege to nurture a new prospective colleague and to receive assistance in
implementing teaching and/or counseling strategies.
What is the cost for each intern? Interns are required to pay the tuition for enrolling in
three 1-unit courses (summer, fall, and spring) through Continuing Education (CES) at
SDSU. The cost is expected to be $555 for the year internship experience.
When are mentors and interns selected and matched? Each spring semester, Steering
Committee members review the applications of potential interns. Mentors select the
individuals they feel best match their needs including teaching, research, or shared
governance interests.
Why should I participate? Mentors have the privilege to nurture a new colleague and to
have assistance in teaching, counseling, and participation in campus shared governance
activities. Interns have the opportunity to learn about the community college system,
culture, and students. Often, they have the chance to assist in the development of
activities and assignments to engage adult learners.
How can I participate? As a potential mentor, contact your Campus Coordinator (listed
on the website). If you are a college wanting to support this program, contact the SDSU
Coordinator (Dr. K. Jeffcoat: office: 619 594-3570; email: kjeffcoa@sdsu.mail.edu).
As a potential intern, review the application process. In the meantime, I suggest you try
to learn as much about the community college system and current issues.
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PROGRAM GOALS AND STRUCTURE
PROGRAM GOALS
Introduce graduate students and students recently completing a Master‘s degree,
to the community college environment and student population.
Arrange successful mentoring relationships that support the development of
interns and mentors as master counseling or classroom faculty members.
Provide training for interns emphasizing assessment of student learning outcomes,
strategies for providing students with basic skills, and strategies to engage a
diverse population of adult learners.
Describe to interns job search techniques as well as address other issues important
as interns prepare for careers as community college teachers or counselors.
Nurture the highest levels of integrity and ethics in every aspect of the
professional life of each intern.
Create a database of current and former interns to enable participating community
colleges to recruit for part-time and full-time faculty members, especially in
disciplines where a shortage is anticipated.
Introduce industry practitioners to the community college environment as they
complete degrees that would qualify them to teach at a community college.
Evaluate the program and disseminate information about the program to interested
parties.
PROGRAM INTERN LEARNING OUTCOMES
Each SDSU course includes specific student learning outcomes to be achieved. In
addition, at the end of this program, interns will be able to:
Describe their strengths and areas needing development in order to be successful
as a part-time or full-time faculty member.
Explain how networking during the internship program has resulted in colleague
relationships that are mutually beneficial.
Articulate a five-year professional plan for counseling or classroom teaching.
VALUE TO THE MENTOR AND THE COMMUNITY COLLEGE:
The intern can serve as comparable to a ―teaching assistant‖ for the mentor, developing
learning activities, quizzes, or exams, screening and suggesting ―You-tube‖ clips, or
reviewing recent professional journal articles. If the intern has completed at least half of
his/her Master‘s program, according to Title 5, the intern can legally serve as a substitute
teacher, following the procedures of that specific community college. The intern also
could assume a more observational role, learning from the faculty member by
―shadowing‖ the mentor and receiving permission to observe other colleagues.
Mentors volunteer to work with a specific intern to develop the intern‘s counseling and
classroom teaching skills. Past interns have attended shared governance meetings and
assisted in campus projects. For example, in the past, interns assisted in the planning and
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implementation of Women‘s History Month and Basic Skills Initiative activities. Interns
have provided input on college processes and procedures. At a time when community
colleges need to do more with fewer resources, interns can serve as highly trained and
effective volunteer colleagues.
PROGRAM ELEMENTS
A SPECIFIC INTERN LEARNING PLAN:
Interns develop a detailed plan with their mentor describing the learning outcomes
for both the intern and the mentor and the activities that will contribute to those
outcomes. This plan is signed off by the mentor, the intern, and the campus
program coordinator.
In addition to attending the Friday workshops throughout the year with cohort
members, interns meet regularly with their mentor as defined in each individual
internship plan.
Interns document their time and the quality of their experiences preparing
classroom materials, guest lecturing, and doing whatever their mentor (and the
intern) deems to be appropriate.
Occasionally, exceptional interns are invited to teach their own section during the
spring semester. If this opportunity takes place, the intern will continue to work
under the direction of a mentor, attend program meetings, and complete the
academic requirements of each ED 997 course.
SAMPLE PLAN:
SDICCCA Faculty Internship Learning Agreements
Please complete this form in its entirety and return it to the SDSU Campus Coordinator. You,
your mentor, the campus coordinator, and the SDSU Internship Coordinator will each receive a
copy of this form.
Student’s Name: ___Mary Jones_________________________________________________
Student‘s RED ID: __8888888888_______________________________________________
Internship Site Mentor’s Name: ___Dr. Fred Smith_______________________________
Community College: ___________________________________________________________
Department: ________________________________________________
Email: ________________________________________________________________
Phone Number: ____________________ Fax Number: _________________________
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Emergency Contact Name: ______________________________________________
Emergency Contact‘s Address: ____________________________________________
Email: ________________________________________________________________
Phone Number: ____________________ Fax Number: _________________________
Dates of Internship Appointment:
From ___________________________ to _____________________
Is the student receiving compensation for this internship appointment?
Yes____ If yes, state agreed compensation terms below.
______________________________________________________
No____ If no, please proceed with the next set of statements.
If the student is volunteering his/her service in your department, will your department be
providing worker‘s compensation coverage for the student during the period of his/her internship
appointment?
Yes ____
No ____
State the learning outcomes for this internship and strategies for achieving these outcomes.
SAMPLE
1. The intern will be able to describe the organizational structure of this community college in
terms of programs under each division and department. Strategies: The intern will review the
college organizational chart and meet with at least three department chairs to learn more about the
programs in that department.
2. The intern will be able to use knowledge about this specific community college to describe
how decisions are made and work gets done. Strategies: The intern will attend at least two
planning councils and one Dean‘s Council meeting.
3. The intern will be able to demonstrate ―good practices‖ in counseling or classroom teaching.
Strategies: The intern will interview his/her mentor and at least two other Counseling or
classroom faculty to identify ―good practices‖ and will practice these approaches at least twice
during each semester.
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4. The intern will be able to explain how ―shared governance‖ really ―works‖ at that particular
community college. Strategies: The intern will attend two Academic Senate meetings, a Board
meeting, and a Dean‘s Council meeting.
5. The intern will be able to discuss ways he/she would strengthen the department if selected as a
part-time or full-time faculty member. Strategies: The intern will discuss and fine-tune these
ideas through a number of structured conversations with his/her mentor.
Attach additional pages if necessary.
We the undersigned agree to the information represented on this sheet and will support and
facilitate the learning stated within. We agree to facilitate the learning in the135 contact hours
over the time specified within this document.
Signature of Student: __________________________________ Date: ____________
Signature of Mentor: ___________________________________ Date: ____________
Signature of Campus Coordinator: ________________________ Date: ____________
Signature of SDSU Program Coordinator: __________________ Date: ____________
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THREE CONTINUING EDUCATION COURSES
Interns must enroll in three ED 997 SDSU courses through the school of ―Continuing
Education‖ (CES). Course completions will appear on the intern‘s transcript and provide
a prospective employer with documentation of the completion of the internship. The ED
997 course is specifically designed for faculty development and is the most inexpensive
way for interns to be enrolled at SDSU. The tuition (expected to be $555 per year)
returns to the University; the tuition does not support interns, program coordinators,
program mentors, or the SDSU program coordinator.
Summer Institute (18 hours)
Fall Institute (18 hours)
Spring Institute (18 hours)
The hours expected for the fall and spring courses include the Friday workshops all
interns attend. Interns are expected to attend at least 90% of the five Friday, 3-hour
workshops per session (and 70% of the summer sessions); in addition, interns are
expected to invest 3-9 weekly hours per week into this program to complete the learning
outcomes in their plan. Interns can receive credit for ARP 760 as a part of the four-
course Community College Teaching Certificate if selected for this program.
SUMMER INSTITUTE AND FRIDAY-AFTERNOON WORKSHOPS:
The program is composed of the following elements:
Enrollment in summer, fall, and spring sessions of ED 997 at SDSU and
completion of the requirements of each of these courses;
Attendance of at least 10 Friday afternoon sessions throughout the year.
Throughout the year, interns and mentors meet on their respective campuses and attend
five-six meetings per session with their cohort members. These meetings are held at one
of the community college campuses in the area. Interns learn the dynamics of becoming
community college faculty members through both campus experiences and information
from other cohort members on intern experiences on other campuses. Mentors and
Steering Committee/Campus Coordinators attend designated sessions and share their
professional experiences with the interns.
At the end of the academic year, each intern is expected to attend the May meeting of the
SDICCCA Presidents where interns are honored and receive a certificate of program
completion. Interns commit to attending a summer celebration event to share their
experiences with interns selected for the subsequent year.
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SCHEDULE: 2010-2011
COMMUNITY COLLEGE FACULTY INTERNSHIP PROGRAM
INSTITUTE SCHEDULE, FALL 2010 - SPRING 2011
DAYS: FRIDAYS AT DIFFERENT COMMUNITY COLLEGE
CAMPUSES (Except for the May meeting of the SDICCCA
Presidents held at 9:00 AM, SD County Office of Education)
TIME:
12:30-1:00 Lunch (Bring a sack lunch and beverage)
1:00 – 1:30 Introductions
1:30 – 3:00 Presentation by the Host Community College
3:00 – 3:30 Networking among Interns (and Mentors at designated meetings) *
Mentors should attend these meetings
3:30 - 4:00 Campus tour
DATE MAJOR DISCUSSION TOPICS (Draft) LOCATION (Draft)
TOOLS NEEDED FOR EFFECTIVE TEACHING AND COUNSELING:
September 17* Student Affairs and Critical Thinking Southwestern
October 2 Working with English Language Grossmont College
Learners
October 22* Faculty Member Roles Mesa College
Mentor/Intern Discussions
November 5 Student Diversity Mt. San Jacinto
(Menifee Campus)
December 3* Effective Teaching/Counseling Strategies TBA
Mentor/Intern Discussions
February 4 Faculty Role in Shared Governance TBA
February 18* Faculty Position Creation/ San Diego City College
The Application Process
Mentor/Intern Discussions
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March 4 Panel of New Faculty Hires Palomar College
April 8* Interview Processes Miramar College
Mentor/Intern Discussions
May 2 End of Year Recognition SD County Office of Ed
NOTE: Mentors are invited to meetings with an asterisk. Please encourage your mentor
to attend. Also, the content and location of each session may change over the year.
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SELECTION PROCESS
INTERN ELIGIBILITY:
A potential intern must meet the following minimum qualifications:
1. Currently enrolled in or has completed at least one semester of a one year master‘s; or
one year of a two years master‘s degree program; or, completed a master‘s/doctoral
degree course of study at a regionally accredited college or university in the discipline in
which they plan to teach, counsel, or serve as librarian; or
2. Currently enrolled in, or has completed a bachelor‘s degree course of study at a
regionally accredited college or university and has two years‘ professional experience in
the discipline in which they plan to teach, if a master‘s degree in that discipline in not
expected or available (generally technical, trade, or industrial fields); or,
3. Has met the college-established equivalency standards;
and
4. Demonstrates sensitivity to and an understanding of the diverse academic,
socioeconomic, cultural, disability and ethnic backgrounds of the community college
population.
Note: Foreign degrees must be validated by local accreditation services and determined to
be equivalent to standards established by regionally accredited institutions.
Candidates are then screened by the Steering Committee and applications are evaluated
based on the quality of the writing demonstrated in the essay, the depth and breadth of
professional experience, and the clarity of the teaching/counseling goals. This program is
designed for people committed to community college teaching. Both part-time and full-
time teaching and counseling positions are difficult to acquire.
The application materials are reviewed by at least three Steering Committee members.
Simultaneously, the content of each application is matched to the content of papers
submitted by faculty wanting to serve as mentors. Often candidates perceived as
―outstanding‖ by the Steering Committee are not a ―match‖ with the needs of the faculty
mentor willing to serve as a mentor.
On February 1 of each year, an application invitation is posted on the Interwork Institute
website (interwork.sdsu.edu). Application materials include:
A San Diego / Imperial Counties Community College Regional Faculty Internship
application
A confidential correction questionnaire and notice of fingerprint requirements
An updated résumé
Official transcripts
A one-page essay describing why the applicant wants to become a SDICCCA
Faculty intern
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A Confidential Data Form, which includes information on ethnicity, gender,
citizenship and needs for disability accommodation; this information is analyzed
to confirm breadth of recruitment and are not used in the selection process.
Applications are received and reviewed by the SDSU Program Coordinator to confirm
that applicants meet the minimum qualifications to teach at a California Community
College (www.cccco.edu). Applicants who do not meet minimum qualifications are sent
a letter directing them to the community college system website for further information.
Individuals should not apply for this internship program if they do not meet these
requirements.
SELECTION OF MENTORS:
Prospective mentors are contacted by Campus Coordinators about their teaching, campus,
and research interests and the skills they would want in an intern. The selection criteria
must be unique for each intern/mentor pair. Some mentors are looking for an intern with
similar research interests; other mentors are looking for someone who would provide the
mentor and his/her students with a different perspective.
Campus Coordinators meet to review the files of all applicants, and bring files of
applicants indicating that college as a first choice to that college. If the potential mentor
is impressed with the potential intern‘s application materials, the prospective intern may
be called for an interview. If a ―match‖ is made, the Campus Coordinator or the mentor
informs the intern of being selected for the program. Often, very impressive applicants
cannot be matched with a mentor for a number of reasons. Applicants must understand
this reality prior to initiating the application process.
Potential mentors and campus coordinators never know the demographic background,
academic, or ability diversity of each applicant. The SDSU program coordinator receives
this information and uses it only to confirm program recruitment has been broad and has
resulted in diverse applicants.
SUPPORT:
This program is supported by each of the community colleges in San Diego and Imperial
County. Mt. San Jacinto College is also a part of the partnership. Each college
contributes $500 to the implementation of this program. In addition, each college
supports interns by involving them in the fabric of the college. Often this includes
invitations to attend or participate in college events and special gatherings specifically to
inform interns about college issues. Some colleges find resources to host a special lunch
or reception for their interns. Colleges provide interns with a parking pass for the year
and guide them in completing procedures important for access to students (fingerprinting
and TB testing, for which there is a fee) or campus services (Blackboard, WebCT,
campus email). Some colleges ask interns to sign a volunteer form. Some colleges
require that interns be approved by the District Board of Trustees.
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RESPONSIBILITIES
INTERNS
Interns sign a document agreeing to cooperate with his/her mentor, attend at least 90% of
all required sessions, and complete the requirements of the program. Interns are expected
to complete all commitments and demonstrate professionalism and high ethical standards
at all times.
MENTORS
Mentors volunteer to participate in this program because of their interest in and passion
for the development of the next generation of community college counselors and
classroom faculty. Each college is encouraged to provide support for the SDICCCA
program, especially each mentor. Mentors are expected to fulfill the responsibilities
described in this document.
CAMPUS COORDINATORS
Campus Coordinators are responsible for designing the year-long campus program of
their community college that integrates interns into the fabric of the college community.
Campus Coordinators organize the Friday afternoon program taking place at their
campus. This session consists of a 1-3 hour presentation on a topic of specific interest to
interns and consistent with the curriculum for the year. Usually coordinators meet with
other colleagues, especially senior management, to confirm resources for the program
and ways to include the intern appropriately in campus activities. Campus Coordinators
function as the ―hands on‖ campus representative for the SDSU Program Coordinator and
act as the principle resource for the mentors and interns at each campus. In addition to
representing the college at the program Steering Committee meetings at least twice a
year, the Campus Coordinator provides continuity for the program from year to year.
They are encouraged to suggest new content that will provide the most up-to-date
information for the interns. The Campus Coordinator also confirms that the
mentor/internship relationship is proving productive for both, advises interns on job
application procedures, and reviews the content of their application packages.
Responsibilities include securing a parking pass for the year for their interns; providing
interns with access to appropriate email, Blackboard/Web CT, and college electronic
services. The parking pass is of particular importance since the pass is honored at all
SDICCCA colleges, and interns are eager to spend time on all community college
campuses.
Please verify that interns have completed the TB test, fingerprinting process, and any
other forms/procedures unique to your college. Some colleges include specific forms for
volunteers that are processed through Human Resources.
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By involving the interns in many campus activities and making them extremely visible to
your colleagues, it is hoped that numerous faculty will see the many ways interns provide
faculty with support. Coordinators should be recruiting faculty mentors throughout the
year. A meeting of all campus coordinators is scheduled each year at the end of March to
begin the process of reviewing applications and analyzing the curriculum.
SDSU PROGRAM COORDINATOR
The SDSU Program Coordinator is responsible for teaching the summer ED 997 course
and coordinating the application, selection, and curriculum for the interns. The
coordinator also notifies interns of the details for the monthly meetings and programs at
each college while nurturing a professional relationship with deans and department chairs
at each college to promote the program and encourage support. The SDSU Program
Coordinator confirms that all students have met the requirements of each of the ED 997
courses, grades all papers (pass/fail basis), and submits grades to the SDSU Registrar.
The SDSU Program Coordinator is expected to invest at least 8 hours per week
throughout the year in fulfilling these responsibilities. The SDSU Program Coordinator
will review applications with a community college human resources specialist to confirm
potential mentors have met minimum qualifications for classroom teaching or counseling
and call a meeting of campus coordinators to begin the matching of intern applications to
potential mentors.
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PROGRAM HISTORY
The program was launched in 1994. Each year approximately 30 – 50 selected interns
have completed training. Since the program‘s inception, almost 500 interns have
participated in the program. The program has enhanced the professional skills of interns
and increased the likelihood of interns being selected for a part-time or full-time
community college faculty position.
AUTHORIZATION
Title 5
California Code of Regulations, Subchapter 5
Faculty Internship Program
General Authority
―The governing board of any community college district may establish a faculty
internship program pursuant to the provisions of this Subchapter and Section 87487 of
the Education Code. In accordance therewith, governing boards may employ, as faculty
interns within the program, graduate students enrolled in the California State University,
the University of California, or any other accredited institution of high education subject
to Chapter 3 (Commencing with Section 94300) of Part 59 of the Education Code or in
vocational and technical fields where a master‘s degree is not generally expected or
available, persons who are within one year of meeting the regular faculty minimum
qualifications. Persons who meet the regular faculty minimum qualifications, but who
lack teaching experience, may also be included in internship programs authorized by this
Section to the extent authorized by the local governing board. A student employed as a
faculty intern shall be employed as a temporary faculty member under Section 87482.S of
the Education Code and shall meet the minimum qualification specified in Section 53502.
―For purposes of this Subchapter, the term ‗faculty intern‘ does not include any person,
no matter how designated, who only assists in a class taught by a regularly qualified
member, and who has no independent responsibility for instruction or supervision of
students. Such a person may be termed an ‗intern,‘ and may serve as a volunteer or
receive a stipend according to policies established by the district.
NOTE: Authority cited; Sections 70901 and 87487, Education Code. References:
Section 87487, Education Code.
History
1. New section filed 4-3-92; operative 504-92 (Register 92, No. 15).
2. Amendment filed 9-6-94; operative 10-6-94, submitted to OAL for printing only
pursuant to Education Code section 70901.5 (Register 94, No. 38).
3. Amendment of first paragraph filed 9-3-96; operative 10-3-96. Submitted to OAL for
printing only (Register 96, No. 40).
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FORMS
Unpaid Service-Learning Agreement
University and Community-Based Organization
This Agreement entered into this __ day of ________, ____ between the Trustees of the California State University
on behalf of San Diego State University, referred to as ―UNIVERSITY,‖ and ____________________, referred to
as ―COMMUNITY-BASED ORGANIZATION.‖
I. Statement of Purpose
A. The University… provide a description of the ways in which your department is committed to service
learning.
B. The Community-Based Organization (Name)…provide the mission of the organization.
C. COMMUNITY-BASED ORGANIZATION and UNIVERSITY recognize the opportunity for
meaningful learning experiences for the UNIVERSITY, COMMUNITY-BASED ORGANIZATION
and service-learning students (STUDENT). The UNIVERSITY supports the goals and objectives of
the COMMUNITY-BASED ORGANIZATION program in which STUDENT will participate.
II. Priorities
A. Program Activities
Activities will be accomplished in accordance with the Learning Plan, reviewed and agreed upon
by the STUDENT, UNIVERSITY AND COMMUNITY-BASED ORGANIZATION prior to the
start of the experience.
The STUDENT will:
1. Participate in all relevant trainings required by the COMMUNITY-BASED
ORGANIZATION and stated in Section III-A-2, Training and Orientation of this document.
2. Model professional and appropriate behavior when working with clients, and when on
COMMUNITY-BASED ORGANIZATION site.
3. Support COMMUNITY-BASED ORGANIZATION events that are a part of the service-
learning experience as required by faculty member.
4. Meet the goals of the COMMUNITY-BASED ORGANIZATION program and the service-
learning course in which the STUDENT is enrolled.
5. Add any additional duties specific to the scope of work. Please be as specific as possible in
this section or attach an amendment and reference it here.
B. Safe and Productive Environment – reference COMMUNITY-BASED ORGANIZATION‘s policy
about safe work environment.
1. COMMUNITY-BASED ORGANIZATION will:
a. Give STUDENT a complete tour of the site, and ensure that STUDENT is aware of
all emergency procedures and is able to act responsibly in the case of an emergency.
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b. Ensure that STUDENT is aware of the unique nature of the population of the
________________ program, and is prepared to work with this population.
c. California law may require the COMMUNITY-BASED ORGANIZATION to obtain
STUDENT‘s fingerprints and submit them to the Department of Justice, and/or the
Federal Bureau of Investigation, for a criminal background check. It is the
COMMUNITY-BASED ORGANIZATION‘s responsibility to: 1) determine
whether such fingerprinting is required; 2) obtain the STUDENT‘s fingerprints; and
3) obtain criminal background clearance from the appropriate agency.
2. UNIVERSITY will ensure that STUDENT agrees to the following:
a. Abide by COMMUNITY-BASED ORGANIZATION rules and regulations while on
site and working with COMMUNITY-BASED ORGANIZATION clients.
b. Ensure that his/her interactions with clients are safe, positive and productive.
c. Support the program and its objectives by providing support for clients or
COMMUNITY-BASED ORGANIZATION staff as necessary and agreed upon in
Section II-A-1, Program Activities of this document.
d. Add any other pertinent information regarding specifics of the site and the nature of
the service learning work experience.
III. Structure and Support of Service-Learning Student
A. COMMUNITY-BASED ORGANIZATION
1. Site Supervision – (Name of Site Supervisor responsible for safety and participation of
STUDENT while on site). Site Supervisor will meet with the STUDENT at least (give
number of times per week/month/semester) to update him/her on projects and to provide
support. All program staff will support the STUDENT as they interact with him/her, and
provide guidance and advice as necessary and appropriate. A secondary site supervisor (give
the name of this person) will be responsible for the STUDENT in the absence of primary
supervisor.
The COMMUNITY-BASED ORGANIZATION director or his/her designee will meet (give
number of times per week/month/semester) with (Name) , faculty member at UNIVERSITY
that has assigned the service-learning experience. The initial meeting should aim to facilitate
the most mutually beneficial experience for all parties involved.
2. Training & Orientation – (Name of Site Supervisor or designee) will provide specific training
needed by the STUDENT prior to his/her working with clients or providing service to the
COMMUNITY-BASED ORGANIZATION. Necessary training can be provided through
collaboration between COMMUNITY-BASED ORGANIZATION, UNIVERSITY, and
faculty member.
3. Work Space – STUDENT will have an appropriate space at the COMMUNITY-BASED
ORGANIZATION site in which to conduct his/her assigned work. COMMUNITY-BASED
ORGANIZATION will provide access and training for any and all equipment necessary for
STUDENT to fulfill his/her required service role.
4. Evaluation – The COMMUNITY-BASED ORGANIZATION site supervisor will fill out
survey(s) regarding quality of service that the STUDENT provided to the site, and as agreed
upon in the Learning Plan document.
FINAL – JULY 1, 2010
B. UNIVERSITY - UNIVERSITY will assign STUDENT to the COMMUNITY-BASED
ORGANIZATION from (COURSE NAME), STUDENT can provide service to the _________
program that (describe the program or initiative that the STUDENT will be participating in).
1. Training and Reflection - UNIVERSITY will provide a training session for STUDENT
regarding his/her responsibilities as described in Section II. The Faculty Member (can be
named specifically or just by title) will provide opportunities for STUDENT to reflect on
his/her experience working at the COMMUNITY-BASED ORGANIZATION‘S site.
2. Supervision and Accountability - The STUDENT, COMMUNITY-BASED
ORGANIZATION, and FACULTY member will work closely together to meet the
expectations and priorities of the COMMUNITY-BASED ORGANIZATION‘S site.
IV. Length of Agreement Term
A. Initial Term - The UNIVERSITY and COMMUNITY-BASED ORGANIZATION have reached this
initial agreement for the term beginning ________________ and ending __________________. This
term represents (____school years, calendar years, semesters).
This agreement shall become effective upon execution and shall continue until terminated by either
party after giving the other party 30 days advance written notice of the intention to so terminate;
provided further, however, that any such termination by COMMUNITY-BASED ORGANIZATION
shall not be effective against any STUDENT who at the date of mailing of said notice by COMMUNITY-
BASED ORGANIZATION was participating in said program until such STUDENT has completed the
program as mutually agreed upon.
B. Renewal Process – This agreement can be renewed (decide how often), and is based on STUDENT
feedback, COMMUNITY BASED ORGANIZATION evaluations and FACULTY desire to continue
this relationship for the purpose of service-learning under the conditions that:
1. The UNIVERSITY and COMMUNITY-BASED ORGANIZATION continue to be
committed to actively supporting the goals of the other.
2. The STUDENT work is meaningful and helps to provide essential support to the
COMMUNITY-BASED ORGANIZATION.
3. The relationship is consistent with the goals of the COMMUNITY-BASED
ORGANIZATION, UNIVERSITY, STUDENT and the service-learning course.
A renewal process is only applicable if the faculty member intends to continue placing service-learning
students at this site for the foreseeable future, or if this site can be used for other service-learning
opportunities and that the partnership should be kept up to date with an ongoing MOU.
The attached General Provisions, consisting of two pages, is incorporated by reference and made a part of
this agreement.
FINAL – JULY 1, 2010
This document reflects my understanding of the relationship.
COMMUNITY-BASED ORGANIZATION SAN DIEGO STATE UNIVERSITY
_________________________________ ____________________________________
Authorized Signatory Contract and Procurement Management
_________________________________ ____________________________________
Print Name Print Name
_________________________________ ____________________________________
Date Date
_________________________________ ____________________________________
Street Address Faculty Chair
_________________________________ ____________________________________
City State Zip Print Name
_________________________________ ____________________________________
Phone Email Date
____________________________________
Faculty
____________________________________
Print Name
____________________________________
Date
FINAL – JULY 1, 2010
General Provisions
Indemnification
The community-based organization shall be responsible for damages caused by the negligence of its directors,
officers, agents, employees and duly authorized volunteers occurring in the performance of this agreement.
San Diego State University shall be responsible for damages caused by the negligence of its directors, officers,
employees and duly authorized volunteers occurring in the performance of this agreement. It is the intention
of the community-based organization and the University that the provision of this paragraph be interpreted to
impose on each party responsibility for the negligence of their respective directors, officers, employees and duly
authorized volunteers.
Insurance
The community-based organization shall procure and maintain General Liability Insurance, comprehensive or
commercial form with $1,000,000.00 minimum limit for each Occurrence and minimum limit of $2,000,000.00
General Aggregate, as mutually agreed upon for this placement.
The California State University system has elected to be insured for its General Liability exposure through the
self-insured CSU Risk Management Authority.
The State of California has elected to be self-insured for its vehicle liability and Workers’ Compensation and
property exposures. As a State agency, the California State University, Office of the Chancellor, the Trustees,
and the CSU system of campuses are included in this self-insured program.
The University shall provide professional and personal general liability coverage for students performing
community service or volunteer work for academic credit, through the Student Academic Field Experience for
Credit Liability Insurance Program (SAFECLIP). The coverage limits under this program are $2,000,000.00 for
each Loss and $10,000,000.00 Aggregate for all Covered Parties, and not per student. Any affiliate institution
to whom the Named Insured is obligated by written agreement to provide such coverage as is afforded by this
policy, shall be named as an additional insured.
The University shall provide professional, personal general liability, and educator’s errors and omissions liability
coverage for students enrolled in Nursing, Allied Health, Social Work, or Education credential programs
performing community service or volunteer work for academic credit, through the Student Professional
Liability Insurance Program (SPLIP). The coverage limits under this program are $5,000,000.00 for each Loss
and $15,000,000.00 Aggregate for all Covered Parties, and not per student. Any affiliate institution to whom
the Named Insured is obligated by written agreement to provide such coverage as is afforded by this policy,
shall be named as an additional insured.
Status of Students
Students shall at no time throughout this agreement be considered officers, employees, agents or volunteers of
the University.
Governing Law
All contracts and purchase orders shall be construed in accordance with, and their performance governed by,
the laws of the State of California. Further, community-based organization shall comply with any state or
federal law applicable to community-based organization's performance under this Contract.
Assignments
Without written consent of the CSU, this agreement is not assignable by the community-based organization
either in whole or in part.
FINAL – JULY 1, 2010
Agreement Alterations & Integration
No alteration or variation of the terms of the agreement shall be valid unless made in writing and signed by the
parties hereto, and no oral understanding or agreement not incorporated herein shall be binding on any of the
parties hereto.
Endorsement
Nothing contained in this Agreement shall be construed as conferring on any party hereto any right to use the
other party’s name as an endorsement of product/service or to advertise, promote or otherwise market any
product or service without the prior written consent of the other parties. Furthermore nothing in this
Agreement shall be construed as endorsement of any commercial product or service by the University, its
officers or employees.
Survival
Upon termination of this contract for any reason, the terms, provisions, representations and warranties
contained in this agreement shall survive expiration or earlier termination of this agreement.
Severability
If any provision of this agreement is held invalid by any law, rule, order of regulation of any government or by
the final determination of any state or federal court, such invalidity shall not affect the enforceability of any
other provision not held to be invalid.
Entire Agreement
This agreement constitutes the entire agreement and understanding of the parties with respect to the subject matter hereof and
supercedes all prior agreements, arrangements, and understandings with respect thereto. No representation, promise, inducement, or
statement of intention has been made by any party hereto that is not embodied herein, and no party shall be bound by or liable for
any alleged representation, promise, inducement, or statement not set forth herein.
FINAL – JULY 1, 2010
INTERN APPLICATION
For office use only
NAME: Last _____________________________________ ( ) Completed Application
( ) Resume
First ____________________________________________ ( ) Transcripts
SUBJECT/DISCIPLINE: ___________________________________________________________
* REGIONAL FACULTY INTERNSHIP OPPORTUNITIES *
The Program
The San Diego Imperial Counties Community College Association (SDICCCA) is seeking to recruit, train,
and place interns in classroom teaching, librarian, or counseling positions in nine San Diego County
Community Colleges: Cuyamaca College, Grossmont College, Imperial Valley College, MiraCosta
College, Palomar College, San Diego City College, San Diego Mesa College, San Diego Miramar College,
Southwestern College, and Menifee Campus, Mt. San Jacinto College.
The San Diego County community colleges will provide developmental opportunities for persons interested
in pursuing a community college teaching career through one-year internships which pair interns with
discipline-related mentors. This program is intended to help develop a pool of potential candidates which
reflects the diversity of community colleges for possible future adjunct or contract teaching positions.
Applicants from historically underrepresented groups including women are encouraged to apply.
In order to meet minimum qualifications, interns must:
be enrolled in and at least halfway through a Master‘s Program, or have completed a master‘s/doctoral
degree course of study at a regionally accredited college or university in the discipline in which they
plan to teach, counsel, or serve as librarian; or
be enrolled in, or have completed a bachelor‘s degree course of study at a regionally accredited college
or university and have two years‘ professional experience in the discipline in which they plan to teach,
if a master‘s in that discipline is not expected or available (generally technical, trade, or industrial
fields); or
have met the college-established equivalency standards; and,
demonstrate sensitivity to and understanding of the diverse academic, socioeconomic, cultural,
disability and ethnic backgrounds of the community college student population.
Terms and Conditions
Once accepted to the program, interns will be expected to sign a letter of commitment agreeing that under
the direction of an assigned mentor, they will:
spend time with their mentor in the appropriate academic setting, observing educational methodology;
FINAL – JULY 1, 2010
present lectures, team teach, provide classroom instruction, conduct counseling sessions, or perform
other academic duties under the direct supervision of the assigned mentor; and,
attend bi-weekly meetings of the Graduate Institute of SDSU.
Internships are for one academic year: Fall 2010 through Spring 2011, with training beginning in the
summer of 2010.
Application process (APPLICATIONS DUE MARCH 4, 2011)
A complete application packet includes this completed application form, a resume, unofficial transcripts
from all regionally accredited collegiate institutions attended, and the enclosed confidential data forms.
Submit applications to:
Dr. Kendra Jeffcoat
San Diego State University
3590 Camino del Rio North
San Diego, CA 92108
www.interwork.sdsu.edu/courses/distance/cc/
00-0101-007
San Diego and Imperial Counties Community College Association
Regional Faculty Internship Application
2010–2011
Please complete the following information and mail or deliver to:
SDICCCA Regional Internships
Dr. Kendra Jeffcoat
San Diego State University
3590 Camino del Rio North
San Diego, CA 92108
(Applications due March 4, 2011)
Instructions: Please type or print clearly; all items must be completed in full. Do not write “see
resume.” The application procedure may include an oral interview or written exercises. If you
have a disability and need accommodation for any part of this procedure, please notify the office
listed above at the time you submit your application.
Name Social Security Number - -
Address City Zip
Home phone ( ) Business/Message Phone ( )
E-mail
Discipline in which you have/will have received a graduate degree:
Indicate the college(s) where you are willing to work (list top 3, #1 being most desirable)
[ ] Cuyamaca College [ ] MiraCosta College [ ] San Diego City College
[ ] San Diego Miramar College [ ] Grossmont College [ ] Palomar College
[ ] San Diego Mesa College [ ] Southwestern College [ ] Imperial Valley
FINAL – JULY 1, 2010
[ ] No preference [ ] Menifee Campus
Education Record: Please list, in order of attendance, all regionally accredited higher educational
institutions attended. (Please attach unofficial transcripts of all collegiate work listed.)
College/University Location Dates Title of Degree Major/Minor # Sem./Qt.
Units
Undergraduate:
Graduate:
Enter total graduate hours earned toward Master‘s degree [ ]; toward Doctoral degree
[ ]
SDICCCA Colleges are equal opportunity/Affirmative Action employers, committed to an educational environment which
affirms and supports a diverse faculty and staff.
Teaching Experience: Have you taught or served as a counselor before? [ ] Yes [ ] No
If yes, please list your experience, beginning with the most recent experience.
Discipline Grade Dates Full or Part Time Supervisor Phone Number or em
Level
Related, Non-Teaching Experience: Please list your experience, beginning with the most recent
experience.
FINAL – JULY 1, 2010
Name of Employer Address Dates Employed No. Position Title/Prima
Hrs./Week Duties
References: Please list three references who can speak to your professional and/or educational experiences.
Reference Name Professional/Educational Relationship Phone Number
FINAL – JULY 1, 2010
In a one-page essay, please explain: (1) why you wish to become an intern in the SDICCCA Regional
Faculty Internship project; and (2) any experience that you have, which you believe makes you especially
qualified to work with our culturally and ethnically diverse student population. This essay must be word
processed. All materials will be submitted electronically via the website that is in the process of being
updated.
Applicant‘s Signature Date
FINAL – JULY 1, 2010
00-0101-007W
Title of Position Applying for:
The San Diego and Imperial Counties Internship Programs
CONFIDENTIAL CONVICTION QUESTIONNAIRE
AND NOTICE OF FINGERPRINT REQUIREMENTS
The information that you are asked to share on this form is confidential. It is separated from, and not
retained with, your application package; it is not seen by those who make decisions. The completion of this
form is MANDATORY. Failure to complete this form will result in your application being disqualified. The
California Education Code requires, in part, that community college districts shall not employ or retain in
employment persons in public school service who have been convicted of any felony, misdemeanor drug
charge or misdemeanor moral turpitude (sexual offense) crime. A conviction for other crimes may not
necessarily disqualify the applicant from the job for which you may be applying.
NOTICE OF FINGERPRINT REQUIREMENTS: Everyone who is offered employment in an academic and
classified position, an hourly assignment , or as an intern is required to submit a set of fingerprint cards for a
background check.
PLEASE PRINT
1. Last Name First Name Middle Name
2. Alias Name (Also known as)
3. Birthdate Social Security Number
4. HAVE YOU EVER BEEN CONVICTED OF ANY FELONY, A MISDEMANOR DRUG
CHARGE, OR A MISDEMEANOR MORAL TURPITUDE (SEXUAL OFFENSE) CRIME?
NO YES IF YES, PLEASE LIST BELOW.
A. Code Violation Section Number: Date of Arrest:
Convicted of:
Place/City of Occurrence:
Disposition/Outcome:
B. Code Violation Section Number: Date of Arrest:
Convicted of:
Place/City of Occurrence:
Disposition/Outcome:
C. Code Violation Section Number: Date of Arrest: _
Convicted of:
Place/City of Occurrence:
Disposition/Outcome:
FINAL – JULY 1, 2010
IF ADDITIONAL SPACE IS REQUIRED, PLEASE PROVIDE THE INFORMATION ON THE
BACK OF THIS FORM OR ATTACH ADDITIONAL SHEETS OF PAPER.
I hereby certify that all statements on this form are true and complete to the best of my knowledge and
belief. I hereby authorize the San Diego Regional Faculty Internship Project to verify police records, and I
have read and understand the fingerprint requirements noted above. If employed, I understand that any
untrue statements on the above record may be considered grounds for termination.
SIGNATURE DATE
00-0101-007
CONFIDENTAL DATA FORM
The Office of Federal Contract Compliance Programs and Title 5 of the California Code of
Regulations requires institutions of higher education to ask applicants to voluntarily submit
information related to ethnicity/race, gender, age, and disabilities. This confidential information is
used only to comply with federal and state reporting requirements and is kept separate from your
application and from members of the screening committee.
Name: Social Security # - -
Address: Phone No.#
Subject/Discipline E-mail:
Have you ever been convicted of any felony, a misdemeanor drug charge, or a
misdemeanor moral turpitude (sexual offense) crime? [ ] Yes [ ] No
If you have responded “yes” you must complete the attached Conviction Questionnaire form.
Do you have a physical or mental impairment which limits one or more major life
activities?
[ ] Yes [ ] No [ ]Do not wish to specify.
Ethnic identification: Please select one group with which you identify as your ethnic group.
[ ] American Indian or Alaskan Native: All persons having origins in any of the original
peoples of North America.
[ ] African American (not of Hispanic origin): All persons having origins in any of the Black
racial groups.
[ ] Asian: All persons having origins in any of the original peoples of the Far East, Southeast
Asia or the Pacific area includes, for example: China, Japan, Islands. This includes
Korea, the Philippine Islands, Samoa and the subcontinent of India.
[ ] Chinese [ ] Asian Indian [ ] Japanese [ ] Korean [ ] Laotian
[ ] Cambodian [ ] Vietnamese [ ] Other Asian [ ] Guamanian [ ] Hawaiian
[ ] Samoan [ ] Other Pacific Islander
[ ] Hispanic: All persons of Mexican, Puerto Rican, Central or South American or other
Spanish culture or origin, regardless of race.
FINAL – JULY 1, 2010
[ ] White (not of Hispanic origin): All persons having origins in any of the original people of
Europe, North Africa, or the Middle East.
Gender: [ ] Male [ ] Female Birthdate:
If you are not a U.S. Citizen, can you provide proof of your legal right as a noncitizen to
remain and work in the U.S.?
[ ] Yes [ ] No
00-0101-007W
FINAL – JULY 1, 2010
MENTOR INQUIRY FORM (Optional)
Mentor Name:
Community College:
Department and discipline:
Graduate school research interests:
Courses you anticipate you will be teaching during the 2010-2011 academic year:
Campus projects, initiatives, or activities you anticipate leading during the 2010-2011
academic year:
Specific ways you would want assistance from your mentor:
Specific forms of experience or academic background you look for in your mentor:
Specific ways you would acquaint your mentor with the dynamics of your community
college:
FINAL – JULY 1, 2010
INTERN PROGRAM AGREEMENT FORM
Faculty interns are expected to:
1. Pay any fees associated with fingerprinting and/or TB testing.
2. Meet with the mentor at regularly scheduled times.
3. Attend all regularly scheduled classes and/or counseling hours.
4. Call upon the mentor as needed with respect to his/her schedule.
5. Carry out specific assignments made by the mentor.
6. Assist the mentor as requested.
7. Meet with and assist students during office hours, as directed by the mentor.
8. Share ideas with the mentor.
9. Receive and offer appropriate suggestions about programs or policies.
10. Discuss their needs and ideas with the mentor so that he/she can help the intern
succeed as a teacher or counselor.
11. Develop sample course materials (syllabi, exams, etc.)
12. Seek outside assistance from the SDICCCA program members, as needed.
13. Participate in the evaluation of the internship program.
14. Participate in activities, workshops, orientations, and training programs that have
been developed for the intern.
15. Enroll in all three sessions of ED 997 and satisfy all course requirements.
16. Attend various campus meetings, such as department/discipline meetings, academic
senate, etc.
17. Develop appropriate course/counseling materials and methods that include
multicultural education.
This agreement is entered into between the Community College District referred to as
―district‖ and ______________________, hereinafter referred to as ―faculty intern.‖ The
district and faculty intern do hereby agree as follows:
1. The faculty intern is expected to work under the immediate supervision of a
faculty mentor during the academic year.
2. The term of this agreement shall be from
_____________________ to _____________________ (dates)
3. Upon successful completion of the faculty internship Fall semester and mutually
agreed upon by the district and faculty intern, the faculty intern may be assigned
one regular lecture class, laboratory class, a combination of the two, a counseling
assignment, or equivalent during the subsequent semester. This assignment is
subject to provision of law, the performance of the intern during the Fall semester,
and the availability of positions. If hired, the faculty mentor will continue to work
with the intern during the second semester.
4. During the second semester, if assigned to teach a section within his/her discipline
or to counseling hours, the faculty intern will be compensated at the regular
FINAL – JULY 1, 2010
hourly rate for adjunct faculty. Placement on the salary schedule is determined at
the time of the assignment and is based upon the procedures used for all adjunct
assignments at that community college.
5. At the completion of the internship, the faculty intern must have met minimum
qualifications for the discipline in order to be considered for future employment.
I certify that I have read and understand the terms and conditions of this agreement and
agree to abide by them.
________________________ _________________
Intern Date
________________________ _________________
Campus Coordinator Date
The laws of the State of California shall govern the terms and conditions of this
agreement, with venue in San Diego County.
FINAL – JULY 1, 2010
MENTOR PROGRAM AGREEMENT FORM
The Faculty Mentor assigned a faculty intern is expected to:
A. Provide the intern with a campus tour, identifying key work related areas such as:
the location of support personnel
where mail may be retrieved
where duplication may be done
location of equipment and supplies
the Human Resources Offices
student support services
B. Meet with the intern prior to the beginning of, or early in, the semester to set up the
following:
regular meeting times
share texts and related teaching/counseling materials
review course syllabi and outlines
assist in completing necessary paperwork
discuss absence reporting
discuss campus safety
C. Meet with the intern regularly.
D. Respond promptly to the intern‘s questions.
E. Introduce the intern to other faculty and staff.
F. Define the intern‘s role in the classroom/counseling office.
G. Assist the intern when he/she is developing course materials, syllabi, assignments,
examinations, etc.
H. Share counseling/teaching responsibilities by allowing the intern to take a more active
role in developing instructional materials, classroom presentations, etc., as the intern
is ready.
I. Provide realistic experiences without exploiting the intern.
J. Help the intern to understand faculty responsibilities beyond the classroom by
discussing issues such as:
shared governance
evaluations
tenure
the basic skills initiative
hybrid and online teaching/counseling
K. Invite the intern to occasional departmental meetings and explain the issues under
discussion.
L. Assist the intern in identifying and engaging in appropriate professional growth
opportunities and goals.
M. Provide and receive appropriate criticism.
N. Discuss the rights and responsibilities of the teacher, in the classroom and beyond.
O. Learn from as well as teach the intern.
P. Interact socially with the intern (lunches on campus, etc).
Q. Participate in the internship evaluation process.
FINAL – JULY 1, 2010
R. Provide the intern with information and assistance on job seeking skills.
S. Assist the intern in developing curriculum and approaches in teaching/counseling that
include diversity and multicultural education.
This agreement is entered into between the Community College District, referred to as
―district‖ and ______________________, hereinafter referred to as ―Faculty Mentor.‖
The district and the faculty member do hereby agree as follows:
1. The faculty intern is expected to work under the immediate supervision of the faculty
mentor during the semester.
2. The term of this agreement shall be from _____________
to _______________ (dates).
I certify that I have read and understand the terms and conditions of this agreement and
agree to abide by them.
__________________________ _______________
Faculty Mentor Date
__________________________ _______________
Campus Coordinator Date
FINAL – JULY 1, 2010
SDICCCA FACULTY INTERNSHIP LEARNING AGREEMENTS
Please complete this form in its entirety and return it to your course instructor two weeks prior to
the start of your internship. You, your site mentor, the campus coordinator, and the SDSU
Internship Coordinator will each receive a copy of this form.
Student’s Name: _______________________________________________________
Student‘s RED ID: ______________________________________________________
Internship Site Mentor’s Name: ______________________________
Community College: ___________________________________________________________
Department: ________________________________________________
Email: ________________________________________________________________
Phone Number: ____________________ Fax Number: _________________________
Emergency Contact Name: ______________________________________________
Emergency Contact‘s Address: ____________________________________________
Email: ________________________________________________________________
Phone Number: ____________________ Fax Number: _________________________
Dates of Internship Appointment:
From ___________________________ to _____________________
Is the student receiving compensation for this internship appointment?
Yes____ If yes, state agreed compensation terms below.
______________________________________________________
No____ If no, please proceed with the next set of statements.
FINAL – JULY 1, 2010
If the student is volunteering his/her service in your department, will your department be
providing worker‘s compensation coverage for the student during the period of his/her internship
appointment?
Yes ____
No ____
State the learning outcomes for this internship. (See the SDICCCA Faculty Internship
Program Handbook for suggestions.)
1.
2
3.
4.
5.
Attach additional pages if necessary.
We the undersigned agree to the information represented on this sheet and will support and
facilitate the learning stated within. We agree to facilitate the learning in the 135 contact hours
over the time specified within this document.
Signature of Student: __________________________________ Date: ____________
Signature of Mentor: _______________________________ Date: ____________
Signature of Campus Coordinator: ________________________ Date: ____________
Signature of SDSU Program Coordinator: __________________ Date: ____________
FINAL – JULY 1, 2010
SDICCCA FACULTY INTERNSHIP
Activity and Learning Log
Intern Name:
Semester:
Mentor: Community College Site:
Date Time In Time Out Hours Activities
Total hours: 0
Site Mentor’s Signature:
Campus Coordinator’s Signature:
FINAL – JULY 1, 2010
SUMMER INSTITUTE EVALUATION FORM
Rate the six sessions of the summer institute based on a 10-point scale from 1 (poor) to
10 (excellent).
Evaluation Items Rating
1. Usefulness of the content of each session
2. Effectiveness of the delivery method for each session
3. Competence of the facilitator/presenters
Scale (1-10) 1=poor, 5=average, 10=excellent
What part of the summer institute did you find most useful?
What suggestions would you make for improving these sessions?
FINAL – JULY 1, 2010
FRIDAY WORKSHOP EVALUATION FORM
Rate the six sessions of the summer institute based on a 10-point scale from 1 (poor) to
10 (excellent).
Date of session:
Topic of session:
Evaluation Items Rating
1. Usefulness of the content of this session
2. Effectiveness of the delivery method for this session
3. Competence of the facilitator/presenters
Scale (1-10) 1=poor, 5=average, 10=excellent
What part of the session did you find most useful?
What suggestions would you make for improving this session?
FINAL – JULY 1, 2010
POST-INTERNSHIP EVALUATION FORM
Feedback from Interns
Please review the experience you have had this year as a SDICCCA Faculty Intern and
agree or disagree with the following statements using the following scale:
1 = Strongly Disagree 2 = Disagree 3 = Undecided 4 = Agree 5 = Strongly Agree
Items Rating
1. The internship experience taught me a great deal about working in a
community college
2. The internship experience prepared me to work in a community
college.
3. The internship experience strengthened my desire to work in a
community college
4. My mentor contributed effectively to my professional growth
5. The graduate institute contributed effectively to my professional
growth
6. The year internship contributed a great deal to my professional
growth.
The internship has greatly improved my understanding of the:
7. Community college hiring processes
8. Community college governance system
9. Community college tenure process
10. Basic skills initiative
At your internship site the
11. Administration was very helpful to my professional development
12. Faculty members were very helpful to my professional development
13. Support services were very helpful to my professional development
14. Internship program staff members were very helpful in my
professional development.
15. I would recommend the internship experience to a friend.
Answer the following questions with “yes” or “no.” YES NO
Did you have the opportunity to teach a section or receive
payment for a number of counseling hours?
What was the most positive experience for you this year?
What suggestions would you make to strengthen the program?
FINAL – JULY 1, 2010
SDICCCA Faculty Internship Program
Intern FEEDBACK form
Year of participation in SDICCCA Faculty Internship Program:
College where you were an intern:
Discipline/Field of expertise:
Gender: M F
Ethnicity: African-American Asian Latino/a Middle-Eastern Native American
White No response
Evaluation of summer institute: (1=poor, 5=average, 10=excellent)
Institute content: 1 2 3 4 5 6 7 8 9 10
Institute effectiveness: 1 2 3 4 5 6 7 8 9 10
Institute practicality: 1 2 3 4 5 6 7 8 9 10
Evaluation of program: (1=strongly disagree, 2=disagree, 3=undecided, 4=agree, 5=strongly agree)
The internship taught me a great deal about working in a community college: 1 2
3 4 5
The internship prepared me to work in a community college: 1 2
3 4 5
The internship strengthened my desire to work in a community college: 1 2
3 4 5
My mentor contributed a great deal to my professional growth: 1 2
3 4 5
The graduate institute contributed a great deal to my professional growth: 1 2
3 4 5
The Fall semester internship contributed a great deal to my professional growth: 1 2
3 4 5
The internship has greatly improved your understanding of the
community college hiring process: 1 2
3 4 5
community college governance system: 1 2
3 4 5
community college tenure process: 1 2
3 4 5
At the internship site:
administration was very helpful to my professional development: 1 2
3 4 5
faculty members were very helpful to my professional development: 1 2
3 4 5
support services were very helpful to my professional development: 1 2
3 4 5
Internship program staff were very helpful to my professional development: 1 2
3 4 5
I would recommend the internship experience to a friend: 1 2
3 4 5
Evaluation of my performance during the SDICCCA faculty internship: (1=poor, 5=outstanding)
Attendance/accessibility: 1 2 3 4 5
Carrying out specific assignments: 1 2 3 4 5
FINAL – JULY 1, 2010
Functioning independently: 1 2 3 4 5
Communicating with mentor: 1 2 3 4 5
Responding to feedback from mentor: 1 2 3 4 5
Communicating with students: 1 2 3 4 5
Learning about the college: 1 2 3 4 5
Participating in college activities: 1 2 3 4 5
Confidence to teach/counsel: 1 2 3 4 5
Overall performance: 1 2 3 4 5
Current employment status
I am now a full-time counseling/faculty member at a community college: YES NO
I am now a full-time tenure-track counseling/faculty member at a community college: YES NO
I worked this spring or will be working this summer or fall as part-time, adjunct
counseling/faculty member at a community college: YES NO
If yes, how many sections have you/are you teaching?_____
Are you teaching at more than one community college? YES NO
I am fully employed outside of higher education: YES NO
I am seeking part-time employment at a community college: YES NO
I work part-time outside of higher education: YES NO
I am not employed at this time: YES NO
SDICCCA Faculty Internship Program
Mentor FEEDBACK form
Year of participation in SDICCCA Faculty Internship Program:
College where you are a faculty member:
Discipline/Field of expertise:
Evaluation of program: (1=strongly disagree, 2=disagree, 3=undecided, 4=agree, 5=strongly agree)
The intern demonstrated understanding about working in a community college: 1 2 3 4 5
The intern is prepared to work as an adjunct in a community college: 1 2 3 4 5
Evaluation of the performance of the intern during the SDICCCA faculty internship: (1=poor,
5=outstanding)
Attendance/accessibility: 1 2 3 4 5
Carrying out specific assignments: 1 2 3 4 5
Functioning independently: 1 2 3 4 5
Communicating with mentor: 1 2 3 4 5
Responding to feedback from mentor: 1 2 3 4 5
Communicating with students: 1 2 3 4 5
Learning about the college: 1 2 3 4 5
Participating in college activities: 1 2 3 4 5
Confidence to teach/counsel: 1 2 3 4 5
Overall performance: 1 2 3 4 5
Comments about the intern‘s current skill set:
Suggestions for further skill development:
FINAL – JULY 1, 2010
Strengths you found in the Internship Program:
Suggestions of ways the program could be more effective: