IIC Intern Agreement

Host Agency/Bureau*

Example: USFS - Fishlake

Host Agency Location*

Will the intern's physical worksite location be in the state of Utah?*

YesNo

Is this internship remote?*

YesNo

Intern's physical worksite location (This is for tax purposes)*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Intern Name*

First NameLast Name

Title of Internship Position*

Intern Email*

We will send the intern's form to the provided address. Please make sure the address is accurate.

Intern Cell Phone*

Internship Start Date*

MonthDayYear

Will intern be attending intern Orientation ?*

YesNo

Training dates info :

Internship Program : https://www.suu.edu/iic/internship-program.html

Youth Crew : https://www.suu.edu/iic/crew-program.html

Please be aware, the IIC will be changing end dates to correspond with available funding once IIC Staff reviews the budget. We will not terminate interns before contacting the mentors first.

Proposed Internship End Date*

MonthDayYear

Student Status*

SUU StudentNon SUU Student (This includes students from other universities, high school students, or recent graduates.)

Season*

Season 1: Fall Season (October - March) Start date will be October 1st or 16thSeason 2: Summer Season (April - September) Start date will be April 1st or 16thCrew Program (May - August)

Non SUU interns are limited to 1500 hours max with the IIC*

Full Time without extension: 40 hrs. a week up to 960 hours for 24 weeks (averages about 6 months)Full Time with extension: 40 hrs. a week up to 960 hours for 24 weeks (averages about 6 months) & 29 hrs. a week for 540 hours for 18 weeksPart Time: 29 hrs. a week

All internships are limited to 1500 hours in a calendar year*

Full Time: 40 hrs. a week for 960 hours for 24 weeks (averages about 6 months). This will depend on SUU’s Spring semester end date and Fall start datePart Time: 20 hrs. a weekCrew Program (Youth Crew Member, 10 weeks/approx. 400 hours)Crew Program (Adult Crew Member/Crew Leader, 13 Weeks/approx. 520 hours)

Will the intern be driving a Federal or State vehicle for internship related work?*

YesNo

Please know before your intern can start driving, they will need to complete all driving courses with us including Federal, State and OHV-off roading. (This includes interns working out of the state of Utah)

If they have already completed their training, please have them email us their certifications or they can upload them in the online training course.

Please make sure to send Shannon Eberhard shannoneberhard@suu.edu in our office the federal vehicle information before your intern starts driving, or fill out below:

	Agency	Location	Make	Model	Year	VIN	License #
Driver 1
Driver 2
Driver 3

I confirm and approve the intern listed in this agreement to drive a state or federal vehicle for the duration of their IIC internship:

Field Office Manager or Agency Superintendent Name:*

Hourly Pay Rate*

Pay raises must be submitted separately and a minimum 2 weeks prior to pay raise date

Work Assignments*

Enter brief description of duties

Host Agency Orientation & Training Requirements*

Certifications, conferences, formal training intern may attend

Certifications I would like my intern to complete / attend during the main intern orientation in May & June. Interns attending a virtual orientation or after the main orientation in early May or June should be listed as "not applicable":

Select Applicable Certifications:*

Federal Defensive Driving (needs to be re-certified every 2 years) (Can be completed with IIC orAgency)CPR / First Aid (needs to be re-certified every 2 years) (Can be completed with IIC orAgency)State Defensive Driving (Required for all interns driving federal vehicle and completed with IIC)OHV -Off Roading Driving (Required if driving a federal vehicle) (Can be completed with IIC orAgency)FISSA (will need to be completed with Agency)Pesticide (will need to be completed online or with agency)None: My intern will be attending the main orientation but no Certifications are needed this yearNot applicable: My intern will not be starting their internship until after the Orientation in May or June.Other

Mentoring *

Describe planned activities/actions that support the Academic, Professional, and Personal development of the intern. (Describe planned activities/actions that support the Academic, Professional, and Personal development of the intern. The IICrecommends an initial goals/expectations meeting, regular check ins, career advice, a midseason goals/expectation check in, anda final goals/expectation debrief.

Evaluation Procedures

Intern and Mentor will each complete two evaluations, one mid-season and the other at the end of the internship. These will be emailed to you by the IIC. These are important tools that help provide data for IIC reporting as well as provide feedback on the IIC program.

On-Site Host Agency Mentor Contact Information
*This needs to be whomever will oversee interns day-to-day activities*

Onsite Mentor Name*

First NameLast Name

Onsite Mentor Position*

Onsite Mentor Phone Number*

Area CodePhone Number

Onsite Mentor E-mail*

Will there be multiple Mentors for this internship?

YesNo

Onsite Mentor Name*

First NameLast Name

Onsite Mentor Position*

Onsite Mentor Phone Number*

Area CodePhone Number

Onsite Mentor E-mail*

Onsite Mentor Name

First NameLast Name

Onsite Mentor Position

Onsite Mentor Phone Number

Area CodePhone Number

Onsite Mentor E-mail

Internships are subject to SUU Policy #6.3: Internships.
By signing this agreement, you agree that you have read and understand this policy

Photo Release:

By submitting this agreement, you hereby give permission to Southern Utah University and the IIC to use your name and photographic likeness, without restriction, in all forms and media for advertising, trade, and any other lawful purposes. You agree that there is no consideration or compensation due as a result of granting this permission.

Agency Mentor's Responsibilities:

Provide planned and supervised opportunities for each intern to perform tasks to acquire and practice various skills based on objectives compatible with those of SUU's program;
Orient the intern to the employee's rules, policies, procedures, methods, and operations;
Perform risk assessments and provide orientation to the intern of known or reasonably likely risks;
Evaluate the intern's performance and notify SUU's Internship Coordinator of any cause of dissatisfaction with or of any known misconduct on the part of the intern;
Comply with all federal, state, local, and municipal laws, ordinances, and codes applicable to Agency;
Accept responsibility for supervising the intern at the internship site.
Agency's grant interns the following limited uses to works they create under the terms of the internship:
- The right to claim attribution, maintain copies or files of the work, and to display work in professional portfolios; and
- to derive other works from the works created as interns unless the work has resulted in a patent or other licensable property.

Upon successful completion of the Internship and "Eligibility Packet", the intern may become eligible for one or more federal hiring authorities.

Any other requirements, expectations, or related internship documentation, as established by the Host Agency, should be appended to this agreement.

Additional documentation (if needed)

Upload a File

Mentor Agreement*

I agree to the terms and conditions set by this Agreement.

Intern Information

Interns Driving Federal Vehicles

Internship Information

Internship Costs

Internship Details