Human Services Field Experience I, II, and IIIInternship PacketTHE FOLLOWING PROCEDURES MUST BE FOLLOWED/COMPLTED BEFORE YOU CAN BE REGISTERED for the Human Services Supervised Field Experiences I, II, and III and for the mandatory professional seminars.Complete and submit with required signatures, as indicated, the following documents:Co-Op Ed in Library 100- All Documents must be typed & approved by the faculty supervisor.A. Registration in CareerLink, uploaded & approved rsuma. Misc Section updated for each field experience.B. Copy of HS Internship Packet and job description (if not obtained through Co-Op Ed) uploaded into CareerLink in the Co-Op Ed document sectionC. Learning Agreement/HS Contract (signed by student, site supervisor, faculty Supervisor, and Co-Op Ed Specialist) turned into Co-Op EdD. Submit completed and signed documents to the Co-Op Ed Specialist in LI 100.Human Services-All Documents must be typedA. HS Field Experience Internship Packet Upload into CareerLink Application for Internship Internship Goal Statement and EvaluationB. Email of the complete HS Field Experience Internship Packet to: Faculty Supervisor Agency Supervisor Yourself*Students must submit signed copy of the goal packet to the faculty supervisor at the end of the semester documenting midterm and final evaluations.C. Submit completed and signed documents to the Human Services Secretary in Apsaruke Hall, Room 107.RegistrationWhen all necessary and complete paperwork is turned in the Co-Op Ed Specialist, Mandy Brottem, will register you.QuestionsContact Mandy Brottem, Co-Op Ed Specialist, at 657-1717, mbrottemmsubillings.edu or at LI 100. Students are responsible to make any required copies of their Co-Op Ed internship documents. Hours of participation documentation and Midterm/Final evaluations must be completed and submitted to your Seminar Instructor by the dates specified in the seminar class syllabus. THE DUE DATES ARE YOUR RESPONSIBILITY. Failure to submit these documents as requested will result in an “Incomplete” grade for this internship.APPLICATION FOR INTERNSHIPHS 496Professional Seminar: HS 387 HS 487 HS 489(Semester/Year)(Date m/d/yyyy)Student Name:I.D. #:Address:City:State:Zip Code:Phone Number:Email address:Internship Site name:Agency Supervisor:(Please Type)(Please Type)1. ALL DOCUMENTS LISTED ON THE PREVIOUS PAGE must be completed and submitted before you are eligible to be registered for HS 496.2. Credit hour requirements for internships are based on the formula that each credit hour has a minimum requirement of 45 hours of direct client/agency involvement.3. Each student intern must obtain a copy of the Human Services Internship Manual and be responsible for the contents of the manual.4. There are prerequisites to this internship. Prior completion of all prerequisites is the responsibility of the student.5. Students must register for the appropriate seminar 387 with 496, 487 with 496, or 489 with 496. Seminar attendance is required.INTERNSHIP GOALS STATEMENT AND EVALUATIONThe following INTERNSHIP GOALS, jointly agreed upon and will be achieved to the best of our ability during this academic semester. We realize that Goals may be amended with a copy of the Goals Statement provided to the Human Services Internship Supervisor AS SOON AS POSSIBLE. These Goals will be used when evaluating the student at mid-term, and again at the end of this Internship.AGENCY SUPERVISOR MUST RETAIN A COPY OF THIS GOALS STATEMENT.I. PARTICIPANT EMPOWERMENTThe student intern enhances the ability of the participant to lead a self-determining life by providing the support and information necessary to build self-esteem, personal efficacy, and assertiveness; and to make decisionsA. Supports and assists the participants to develop alternative strategies, make informed choices, follow through on responsibilities, and take risks.B. Promotes participant leadership in the design of support services, consulting the person, and involving them in the support process.C. Provides opportunities for the participant to be a self-advocate by increasing awareness of self-advocacy methods and techniques, encouraging and assisting the participant to speak on his or her own behalf, and providing information on peer support and self-advocacy groups.D. Provides information about human, legal, civil rights, and other resources to facilitate self-advocacy and participant decisions about living, work, and social relationships.Learning Objectives:Meeting Expectations (Midterm):Exceptionally Well Satisfactorily Unsatisfactorily Not Applicable for this ExperienceAccomplished Goal (Final):Exceptionally Well Satisfactorily Unsatisfactorily Not Applicable for this Experience Agency Supervisor Comments:Student