Intern Sponsor Agreement

To be completed by the Internship Supervisor

Student First Name *

Student Last Name *

Internship Information

Your First Name (Intern Supervisor) *

Your Last Name (Intern Supervisor) *

Your Title *

Your Organization *

Street Address *

City *

State

Zip Code *

Country *

Phone Number *

Your e-mail Address *

Website address *

Brief description of intern responsibilities *

Anticipated Start Date *

Month

Day

Year

Anticipated End Date *

Month

Day

Year

Agreement

As a sponsor, I affirm that the student named above will serve as an intern with my organization or project. I agree to provide adequate supervision/mentoring and support so that the intern may carry out agreed upon responsibilities. I will ensure a safe and productive working environment that fosters professionalism and ethical conduct. If this is a Winter Term internship and the student will be receiving credit from Middlebury College, I affirm that this is an unpaid internship. I will provide Middlebury College with an evaluation of the intern’s performance at the end of internship period. I have read and accept the above.

In lieu of a signature, please type your name *

Leave this field blank

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Intern Sponsor Agreement

Center for Careers and Internships