CRIMINAL JUSTICE INTERNSHIP PROGRAMS
UNIVERSITY OF ILLINOIS AT CHICAGO
 Memorandum of Agreement between UIC student and Agency

                                                                                                Date                                       

Student Information

Name                                                                                                                                   Telephone                                           

Address                                                                                                                               UIN #                          ____________

                                                                                                                                            E-mail  _______________________ 

Agency Information

Name                                                                           Supervisor                                           

Address                                                                       Telephone                                           

                                                                                     E-mail  _______________________                       

Agreement

_________________________ has agreed to work from ________ to ________ for       
              (student’s name)                                                                              (starting date)              (ending date)

______

hours a week performing the following agreed upon tasks as part of the field learning experience:

                                                                                                                                               

                                                                                                                                               

                                                                                                                                               

TRAINING AND ORIENTATION

                                                                                                                  

                                                                                                                                               

SPECIAL AGENCY REQUIREMENTS (IF APPLICABLE)

                                                                                                                                                                                               

NOTE:  In the event of illness or emergency the student will contact the agency supervisor.  The student will be responsible to fulfill requirement and commitments to agency as described above.

 Signed:                                                                                      (Agency Supervisor)               

             __________________________________________  (Student)