University of Texas at San Antonio

HSA 6943 Internship Contract

The internship contract is negotiated and prepared jointly by the intern and on-site
supervisor. It is advisable to share a draft with you Faculty advisor and Faculty Internship
Supervisor before finalizing. A copy of the signed contract must be presented to the
Internship Faculty Supervisor no later than the first organized class day for HSA 6943.
The original contract will become part of the students departmental file.
Student Information:
Name: Tiffany Jackson
E-Mail Address: tiffany.celeste.jackson@gmail.com
Mailing Address: 12330 Vance Jackson Apt 1303 San Antonio Texas, 78230
(Telephone number Cell) 267 909-0826
(Telephone number Work) 210 458-6850
Internship Site Supervisor Information:
Name: ____Dr. Patricia Sanchez_______________
E-Mail Address: patricia.sanchez@utsa.edu
Mailing Address: Office: MB 3.302F
(Telephone number Work) 210-458-6461
Dates
Start: August 8, 2016
End:
November 19, 2016
Statement of Purpose:
The purpose of this internship experience is to gain a better understanding of the role of grants at
an institution of higher education. In addition, the internship will allow me to take part in building
a new program at a university. Specifically, this internship will focus on first-generation college
student success and barriers. Objectives of the internship are covered below, and will be
achieved through specific projects. This practicum experience serves as an opportunity to become
familiar with grant funded programs and program management.
Site Supervisor:
The On-Site Internship Supervisor will supervise the work of the student and be the point person
if there are issues related to the students work performance or carrying out of responsibilities.
During the period of the internship, the site supervisor will provide both formative and final
evaluations of the student interns work, using prescribed forms to be provided by the program.
The On-Site Internship Supervisor will also periodically be contacted by the Internship Faculty
Supervisor who will meet with all interns as part of an organized class. The site supervisor
should feel free to contact the Faculty Supervisor as needed.
Revised August 2012; Page 1

The semesters Internship Faculty Supervisor is Dr. Patricia Sanchez and may be contacted by email at: patricia.sanchez@utsa.edu.
Objectives and Learning Outcomes:
Consider carefully the crafting and wording of objectives and learning outcomes as you must
document the successful completion or achievement of each one in your portfolio.
Include one objective on the development and management of budgets as it relates to the
department or program in which you are interning.
Objective 1: To
Learning Outcomes
1. Student will get gain an understanding of the needs of first-generation college students at
UTSA and what types of support they need to succeed. This will be achieved through the
supervision of first-gen peer mentors. Through these interactions, the student will be able to
create meaningful and thoughtful programming to support first-generation student success.
2. Student will create a series of workshops based on the student interest and need. Topics
will include professional interviewing, resume writing, financial readiness, graduate school,
and more.
Objective 2 (and list as many as appropriate to be covered in 150 hours):
Learning Outcomes
1. Student will engage with leadership to learn aspects of managing grant funds and budgets.
Through one-on-on meetings with the supervisor, the student will develop an understanding
of how to track employee wages and maintain the program budget spreadsheet.
2. Student will create first-generation specific resource materials for students and family.
Objective 3
Learning Outcomes
3. Student will take part in developing the first-gen council on campus.
(The final internship contract will be part of your internship portfolio. Keep in mind that
the number and complexity of items listed as internship objectives and learning outcomes
could reflect on your readiness for a student affairs appointment after graduation.)
Site Location:
UTSA, PIVOT For Academic Success
Proposed Work Schedule:
The intern and supervisor have agreed that the work schedule will be . . . . Changes in the
schedule will be made as needed.
Signatures:
Student Signature:
Tiffany Jackson_________________________________________________________________
Revised August 2012; Page 2

Type student name, Graduate Student

Date

Internship Site Supervisor:

Dr. Patricia Sanchez

Type name and title of On-Site Internship Supervisor

Copies:

August 8, 2016
Date

Original signed document to Faculty Supervisor

Revised August 2012; Page 3