Intern Policy Acknowledgment Form
Please review and acknowledge the internship policies by completing all fields below.
Full Name
*
First Name
Last Name
Internship Program/Department
*
Supervisor Name
*
Internship Start Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Please acknowledge you have read and understood the following key policy areas:
*
Attendance and Punctuality
Confidentiality
Code of Conduct
Device/Equipment Use
Reporting Concerns
I acknowledge and agree to comply with all internship policies.
*
I acknowledge and agree
Electronic Signature
*
Date of Acknowledgment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Additional Comments (optional)
Submit
Submit
Should be Empty: