Outlined below are the two types, along with the necessary documentation and processes to ensure proper vetting of internship sites.

Credit Internship: Paid

Student Forms

General Assumption of Risk & Liability

Instructors will need to collect a General Assumption of Risk & Liability from each student registered in an internship credit course. This release form is for the student to understand and acknowledge the following:

• The College is not responsible for medical needs and authorizing its representatives to seek emergency treatment if needed, agreeing to cover all related expenses and release the College from liability.
• Acknowledges the risks involved and agrees to indemnify the College and its affiliates against any claims for losses or injuries.
• Confirming that the student has read, understood, and agreed to the terms outlined in the Release Form, which is governed by Arizona law.

Instructor of Record OR Academic Department Forms

Privacy & Security Questionnaire for Screening (PSQS)

Faculty or Academic Department contact must be signed into email account to gain access to the PSQS Dynamic Form

Internship Site Forms & Requirements

Experiential Education Partnership Agreements (EEPAs) are completed and filled out by the participating internships site agreeing to the following:

The Education Partner is responsible for providing safe working conditions, adequate instruction, and ensuring that students are not exposed to dangerous activities. The students, while not considered employees of MCCCD, will be paid by the Education Partner and covered under their insurance policies for the services they provide.

The Education Partner is responsible for providing safe working conditions, adequate instruction, and ensuring that students are not exposed to dangerous activities. The students, while not considered employees of MCCCD, will be paid by the Education Partner and covered under their insurance policies for the services they provide.

EEPA Student Employee (PAID) For use when a student will be employed and paid by internship site

Certificate of Insurance
A Certificate of Insurance is required to be submitted with the completed EEPA including the following criteria:

1. Commercial General Liability (GL) = Each Occurrence $1,000,000 and General Aggregate $2,000,000

2. Please make sure to add 'Maricopa County Community College District' as a certificate holder and include the following information:

Maricopa Community Colleges
Mesa Community College
Attn: (Instructor or Record or Department Contact)
1833 W. Southern Ave.
Mesa, AZ 85202

3. Named as Additional Insured: Maricopa County Community College District, its agents, officers, officials, employees, and volunteers are hereby named as additional insureds as their interests may appear

Credit Internship: Non-Paid

Student Forms

General Assumption of Risk & Liability

Instructors will need to collect a General Assumption of Risk & Liability from each student registered in an internship credit course. This release form is for the student to understand and acknowledge the following:

• The College is not responsible for medical needs and authorizing its representatives to seek emergency treatment if needed, agreeing to cover all related expenses and release the College from liability.
• Acknowledges the risks involved and agrees to indemnify the College and its affiliates against any claims for losses or injuries.
• Confirming that the student has read, understood, and agreed to the terms outlined in the Release Form, which is governed by Arizona law.

Instructor of Record OR Academic Department Forms

Privacy & Security Questionnaire for Screening (PSQS) will need to be completed and filled out to by academic department or instructor of record to determine if:

• The internship site will need access to the colleges confidential information or data, servers, systems, networks, or any of the colleges storage displaying confidential information.
• Describing the purpose/function of the contract and what the business need is being met by this product or service.

***Faculty or Academic Department contact must be signed into MCCCD email account to gain access to the PSQS Dynamic Form

Internship Site Forms & Requirements

Experiential Education Partnership Agreements (EEPAs)

EEPA (UNPAID) For use when a student will not be employed and not paid by internship site
EEPA Public Entity For use with agencies funded by local, state, or federal money

Experiential Education Partnership Agreements (EEPAs) are completed and filled out by the participating internships site agreeing to the following:

• The Education Partner is responsible for ensuring that Students work in safe conditions and avoiding any risky or dangerous activities.
• They must provide adequate instruction to ensure that the Students' learning needs and the Education Partner's objectives are met and supply written evaluations of the Students' performance upon MCCCD's request.
• Additionally, under the law, Students cannot be used as substitutes for employees and should only be assigned tasks that are educational and beneficial to their vocational or academic development.

Certificate of Insurance
A Certificate of Insurance is required to be submitted with the completed EEPA including the following criteria:

1. Commercial General Liability (GL) = Each Occurrence $1,000,000 and General Aggregate $2,000,000

2. Please make sure to add 'Maricopa County Community College District' as a certificate holder and include the following information:

Maricopa Community Colleges
Mesa Community College
Attn: (Instructor or Record or Department Contact)
1833 W. Southern Ave.
Mesa, AZ 85202

3. Named as Additional Insured: Maricopa County Community College District, its agents, officers, officials, employees, and volunteers are hereby named as additional insureds as their interests may appear.