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STUDENT HANDBOOK
Sponsored by
TABLE OF CONTENTS
Internship Overview
..................................................................................................................................... 1
Internship Frequently Asked Questions
....................................................................................................... 2
Internship Protocols
.................................................................................................................................... 3
Integrating into the Internship Environment
................................................................................................. 5
Internship Assignments
............................................................................................................................... 6
Internship Assignment Check O
.............................................................................................................. 10
Multimedia Presentation Project Grading Rubric
........................................................................................11
Florida Dept. of Education Course Description
......................................................................................... 12
Florida Dept. of Education Dual Enrollment Course Description
............................................................... 13
Self - Evaluation (Sample)
......................................................................................................................... 14
Internship Provider Assessment
................................................................................................................ 15
Internship Forms
........................................................................................................................................ 19
Forms:
 Check List........................................................................................................................ 20
Summer Internship Registration Form ............................................................................ 21
 Emergency Student Data Form (English, Spanish, Kreyol)
............................................ 22
 Social Security Conrmation Form
.................................................................................. 25
 Student Accident Insurance............................................................................................. 26
 Field Trip Permission Form (English, Spanish, Kreyol)
................................................... 27
 Authorization for Photo/Video (English, Spanish, Kreyol)
............................................... 30
Sample of Certicate of Completion
................................................................................ 33
Student Handbook Acknowledgement
............................................................................. 34
 Instructions for TANF Form
............................................................................................. 35
Internship Provider/Student/Parent Responsibility Form SAMPLE ................................. 39
EdFed – The Educational Federal Credit Union Information............................................. 37
Page 1
Rev. 04-7-21
OVERVIEW SUMMER YOUTH INTERNSHIP PROGRAM 2021
DATES/LENGTH July 1, 2021 – August 5, 2021
All eligibility documentation must be submitted by the deadline of May 28, 2021.
Online pre-internship course completion deadline is May 14, 2021.
REQUIRED HOURS 150 HOURS – All hours must be completed during the dates of the
SYIP Program (July 1 - August 5, 2021)
SUGGESTED SCHEDULE 30 HOURS PART TIME WEEKLY (Five Weeks)
WORK MODALITY VIRTUAL, HYBRID or IN-PERSON (following CDC COVID-19 guidelines)
STUDENT POPULATION Rising 10th through 12th Grade high school students between the ages of 15-18
and enrolled in Miami-Dade County Public High Schools
ELIGIBILITY Students must:
• Be eligible to work in the U.S. and be a resident of Miami-Dade County
• Be currently enrolled in a Miami-Dade County Public Schools high school
• Open an account with EdFed – The Educational Federal Credit Union
• Complete the online pre-internship course, submit ALL documents, and register for
internship hiring process through https://miami.getmyinterns.org
• Priority will be given to at-risk students who meet one of the following criteria: Free/
Reduced Lunch or English Language Learners (ELL) or Truant (15 or more
unexcused absences).
INTERNSHIP PROVIDERS All new and former internship providers must register at https://miami.getmyinterns.org
STUDENT INTERVIEWS
METHOD OF
PAYMENT
Note: Organizations can select and hire up to 10 interns during the program. If you
need additional information, please call the internship hotline at 305-693-3005.
Internship Providers may schedule interviews virtually. (Zoom, Microsoft Teams, etc.)
Please Note: The internship provider (Internship Employer) has the nal say on the
selection of the student intern pending that the student has met established criteria.
Sponsored by CareerSource South Florida, The Children’s Trust, Miami-Dade
County,
and EdFed – The Educational Federal Credit Union
1) Summer Youth Internship Program (SYIP)
Students will receive two payments
o 1st payment July 14 - $650.00
o 2nd payment August 11 - $650.00 - after all assignments and timesheets are
submitted to teacher
*Students must open an account by May 28, 2021 with EdFed – The
Educational Federal Credit Union, the official credit union of the SYIP Program
2) Payment by COMPANY PAYROLL – paid directly to student
SUPERVISION A workplace supervisor from the employing organization will evaluate the intern twice
during the internship and an M-DCPS teacher supervisor will be assigned to the intern
and will communicate twice with the workplace supervisor and intern (two on-site or
virtual visits during the 5-week internship period).
STUDENT ACCIDENT THERE IS NO LIABILITY FOR THE EMPLOYER AS ALL INTERNS ARE
INSURANCE REQUIRED TO OBTAIN STUDENT ACCIDENT INSURANCE.
(Football Insurance will not be accepted)
For more information, call the SYIP Hotline at 305-693-3005.
Page 2
Rev. 04-7-21
MIAMI-DADE COUNTY PUBLIC SCHOOLS
2021 Summer Youth Internship Program (SYIP), July 1 through August 5
Frequently Asked Questions (FAQs)
1. What is the Summer Youth Internship Program?
A 5-week work-based learning experience between M-DCPS high school students and businesses and organizations throughout
Miami-Dade County. The Children’s Trust, Miami Dade County, CareerSource South Florida, and EdFed – The Educational Federal Credit
Union are several sponsoring organizations.
2. Who is eligible?
Rising 10th through 12th grade high school students between the ages of 15-18 and enrolled in Miami-Dade County Public Schools.
Students must be eligible to work, reside in Miami-Dade County, open an account with tEdFed – The Educational Federal Credit Union, the
ONLY Financial Institution of the SYIP program, and complete the online pre-internship course. The deadline to complete the online course
is Friday, May 14, 2021. The deadline to complete all eligibility documents and opening an EdFed – The Educational Federal Credit Union
account is Friday, May 28, 2021. The SYIP requires completion of 150 hours during the five-week period, July 1 – August 5, 2021.
3. How do students enroll?
A student must first complete the online pre-internship course by their school’s Teacher Champion and submit required completed docu-
mentation to teacher. Parents and students can contact the Internship Hotline (305-693-3005) to find out more about enrollment and their
Teacher Champion.
4. How are students placed with an employer?
After completion of the online pre-internship course and submission of required documentation, students will be prompted to upload their
resumes to Miami.getmyinterns.org (opening March 29, 2021 for students) where they can begin to apply for jobs with internship providers.
All internship providers have been approved by the Department of Career & Technical Education to hire students. Completing the online
pre-internship course does not guarantee placement into this program.
5. Is this a paid internship?
If students are approved after completing all requirements no later than May 28, 2021, including being hired by a business/organization,
they will receive grant payments or be placed on company payroll. Students will be notified to confirm that they are receiving grant pay-
ments by the Department of Career & Technical Education.
6. How do students get paid?
The Summer Youth Internship Program is sponsored by The Children’s Trust, Miami Dade County, CareerSource of South Florida and
EdFed – The Educational Federal Credit Union. Students will receive TWO (2) payments directly deposited into their EdFed – The
Educational Federal Credit Union, the ONLY Financial Institution of the SYIP Program, account:
• 1st payment of $650.00 – Wednesday, July 14, 2021
• 2nd payment of $650.0 – Wednesday, August 11, 2021
Students must open their credit union accounts by Friday, May 28, 2021, to receive payments on time. If a student already has a
credit union account, they must inform the bank of their participation in the Summer Youth Internship Program. Payments will
be delayed if a student has not turned in their time sheets on time. No more than two absences are allowed, and the required 150
total hours must be completed during the SYIP program from July 1 - August 5, 2021.
7. How are students graded?
Students completing the Summer Youth Internship Program will receive one high school academic credit. Students will be assigned a
teacher over the summer who will collect their assignments and time sheets. Grade calculation: 50 % assignments and 50% internship
supervisor assessment. Students may also receive dual enrollment college credit if they meet Miami Dade College or Florida International
University established criteria and submit required forms by due date set by MDC and FIU.
8. Are students required to have Student Accident Insurance?
All students enrolling in the Summer Youth Internship Program must have Voluntary Student Accident Insurance (Football Insurance is not
acceptable). The insurance fee is nonrefundable. Health insurance that students have on their parents’ or guardians’ plan does not meet
the requirement for Student Accident Insurance.
For more information, please call the Internship Hotline at 305-693-3005
Page 3
Rev. 04-7-21
MIAMI-DADE COUNTY PUBLIC SCHOOLS
SUMMER YOUTH INTERNSHIP PROGRAM (SYIP) PROTOCOLS
July 1 through August 5, 2021
Eligibility Document Deadline: May 28, 2021
Online Pre-Internship Course Deadline: May 14, 2021
Protocols for Schools
1. Administrators recruit and support a staff member to be the “Schoolwide Internship
Champion.” If a school does not have career academies where a CTE teacher can be
the “Schoolwide Internship Champion,” it is suggested that administrators recruit an
available staff member.
2. Recruit interns who meet the eligibility criteria for the Summer Youth Internship Program
(SYIP).
3. Internship Champion facilitates preparation of students with work skills online training
(Odysseyware) and disseminates information concerning internship rules, procedures,
and policies:
o Manage enrollment and grading of online Intern Preparation Course. “Internship
Champion” contacts CTE office for Odysseyware course professional develop-
ment and enrollment of students. Scheduled starting in March 2021.
o Review the Summer Internship Training Program Handbook with the interns
(posted on https://www.ctemiami.net/internships-2021/).
o Support students in obtaining an account with EdFed – The Educational Federal
Credit Union by May 28, 2021 for payment of grant stipends.
o Publicize and encourage parents to attend ONE of the virtual Parent Information
Sessions scheduled May 10, 12, 13, 2021 (English); May 12, 2021 (Separate ses-
sions for Spanish and Creole. Informational flyer posted on https://www.ctemiami.
net/internships-2021/).
4. Collect all required documents and submit to the district office electronically via online
binder (LiveBinder) by May 28, 2021, if documents are not received by this date the
student will not be eligible to participate in the SYIP program.
5. Confirm your students are hired on https://miami.getmyinterns.org/
6. Notify students of SYIP status before the close of school year and give students the
Internship hotline (305-693-3005) so that the students can contact the CTE Department
with placement information or questions after the close of school.
7. Collect and submit by due date to the CTE office all required documents for dual enroll-
ment through Miami Dade College or Florida International University (hard copies) by
due date set by MDC and FIU, if student is eligible.
Page 4
Rev. 04-7-21
Protocols for Students
Pre-Internship:
1. Complete all requirements for eligibility as per checklist by May 28, 2021.
2. Complete Online (Odysseyware) Pre-Internship Course by May 14, 2021.
3. Students will be approved to sign up at https://miami.getmyinterns.org/ upon
comple-tion of Online (Odysseyware) Pre-Internship Course
4. Clarify any scheduling or transportation problems
5. Accept the first position offered
6. Call to cancel any subsequent interviews once a position has been accepted
7. Notify lead teacher/counselor/Internship Teacher Champion at the school and the
CTE office after the close of school year when hired at 305-693-3005.
8. Open an EdFed – The Educational Federal Credit Union account by May 28, 2021.
If not open in time, first payment will be delayed.
During the Internship
1. Work the entire length of the internship (5 weeks/150 hours). All hours must be
completed during the SYIP program dates (July 1 - August 5, 2021).
2. Complete a W-9 when sent to you through Adobe Sign. (Remember information on
this form is your information NOT your parents’ information.)
3. Follow the schedule as assigned by the Internship Provider
4. Complete all assignments as indicated in Student Handbook
5. Observe summer school attendance policies (no more than two absences allowed)
6. Make up any hours for stipend payment purposes, if applicable.
Protocols for Internship Providers
1. Sign-up at https://miami.getmyinterns.org/
2. Registered to do business in the state of Florida and located in Miami Dade County
3. Agree to and sign the cooperative (Internship) agreement (sample in the student
handbook).
4. Assign a worksite mentor
5. Interview the student intern for placement (remotely or in-person)
6. Participate in a virtual internship provider orientation
7. Sign a M-DCPS eld trip form that will allow the worksite supervisor to take the stu-
dent intern o-premises for ocial work-related meetings
8. Ensure that an Emergency Contact Form is on le at the oce for each student intern
9. Review and approve intern’s timecard on a weekly basis and the total timecard at the
end of the SYIP ve-week program
10. Complete an assessment of the intern at the end of the SYIP ve-week program
Page 5
Rev. 04-7-21
INTEGRATING INTO THE INTERNSHIP ENVIRONMENT
Do’s and Don’ts
Do: - be on time. Don’t: - use street language.
- be responsible. - eat at your desk.
- be dependable. - use the Internet for personal
- be cooperative. business without prior approval.
- be honest. - check personal e-mails.
- be pleasant and polite. - chew gum.
- be alert coming and going to work. - play personal music devices
- dress for success. while on the job.
- be a team player - text on the job
Using the Telephone/Cellular Phone
• Ask permission to use the telephone for personal calls.
• If you are permitted to make personal calls, make them short.
• Do not make any long distance personal calls.
• Do not take or make personal calls from your cellular phone.
You and Your Internship Supervisor (at work site)
• Make a note of your supervisors’ names and telephone number both Internship Supervisor and M-DCPS
Instructional Supervisor, in case of emergency.
• If you are ill and cannot go to work, call your Internship Supervisor and the M-DCPS Department of
Career and Technical Education at 305-693-3030, as soon as possible.
• If you become ill at work, notify your Internship Supervisor and ask permission to leave.
• Listen carefully when instructions are given. If necessary, take
notes. Ask questions when you do not
understand the instructions.
• Follow instructions; do not improvise. There may be a reason why a job is done in a particular manner.
• If you are directed to use equipment you are unfamiliar with, ask for instructions.
• Do not risk injuring yourself or damaging the equipment.
• The records you handle are confidential. Do not disclose information you may see.
• Ask your internship supervisor if there is additional work if you feel underutilized.
Getting Along with Others
• If a problem arises, try to solve it with your co-workers. If not, ask for assistance from your internship
supervisor and/or the M-DCPS Instructional Supervisor.
• If you are given an assignment by more than one person, check with your internship supervisor as to
which task takes priority.
• Pitch in and help when things are busy. Be willing to stay after work, however, stay alert and be safe.
• Observe the individuals with whom you work. What characteristics do they have that will help you to
succeed? Work to develop them.
Page 6
Rev. 04-7-21
INTERNSHIP ASSIGNMENTS
The internship assignments are designed to provide experience in and rst-hand knowledge of the
workplace environment. Through these assignments, you will gain skills in the areas of interpersonal
relations, resources, company organization, and technology. These experiences will also help you to
determine your compatibility with a career path. All written assignments must be done on your own
time and must be typed. Complete sentences, proper grammar and punctuation are also essential.
The guidelines for written assignments can be found in the Introduction section of this handbook.
Internship Week, Assignment Theme and Due Date
WEEK 1 RESOURCES
WEEK 2 PLANNING AHEAD
WEEK 3 REFLECTION
WEEK 4 ASSESSMENT
WEEK 5 TECHNOLOGY
Page 7
Rev. 04-7-21
WEEK 1-RESOURCES
After completing this assignment, you will become aware of goals and objectives of the internship, your
job responsibilities, how to develop your personal goals, the importance of time management.
Assignments:
1. Develop a list of personal goals & objectives that you would like to accomplish during your in-
ternship.
a. Set up a meeting time with your internship supervisor to discuss your goals, objectives,
and job responsibilities.
b. From that meeting, formulate a revised outline of realistic goals, objectives, and goal-re-
lated activities as well as the anticipated timeline for completion.
2. Locate the Internship Assessment in the handbook. Review the performance factors.
Explain to your internship work supervisor that the assessment process should be
completed by Week 3. Then, ask the following question and record your internship
supervisor’s responses.
“What criteria will be used to evaluate my performance on the indicators
on the Internship Provider Internship Assessment?”
3. Complete and turn in the time sheet for Week 1. Remember to have your WORK internship
supervisor sign it.
4. If you will be receiving a grant stipend, your funds will be automatically deposited to your
account with EdFed – The Educational Federal Credit Union with two deposits made to your
account during the internship training program depending on whether your hours and as-
signments are turned in on a timely basis.
WEEK 2- PLANNING AHEAD
As an intern, it is important to focus on priorities, goals, and objectives as well as plan ahead.
This knowledge will positively impact your work environment and relationships with co-workers as
well as supervisors. Detailed directions for the nal assignment and an upload link are provided in
the online Internship course.
Assignments
1. Write or attach a document identifying the history, mission, and vision of the internship orga-
nization. Detailed directions and how to submit document will be provided in the online
Internship course.
2. Begin taking/collecting photos for your PowerPoint/Photostory assignment that is due on
Week 5.
3. Complete and turn in the time sheet for Week 2. Remember to have your WORK internship
supervisor sign it.
Page 8
Rev. 04-7-21
WEEK 3- REFLECTIONS
Reection allows an intern to consider the work he/she has provided to an organization and to
better understand their role within the organization. Having the time to reect also gives you the
opportunity for personal growth when you can look within and see the skills that you have acquired
through this internship. Detailed directions and an upload link are provided in the online Internship
course.
Assignments
1. Review the goals you expected to achieve during your internship with your supervisors and dis-
cuss with them the goals you accomplished and explain why you feel achievement occurred. If
your goals were not achieved, clarify why you feel they were not reached.
2. Complete the Self-Evaluation Form and submit the form to your Instructional Supervisor in the
online Internship course. See course lesson for directions.
3. Complete and turn in the time sheet for Week 3. Remember to have your WORK intern supervisor
sign it.
WEEK 4- (03/2<(5ASSESSMENT
During the internship, you have encountered performance skills necessary for workers to function
eectively in high performance organizations that will be able to compete in a global economy.
These skills include problem-solving, reasoning, critical thinking, working in teams, allocation of
resources, interrelationships and systems, and the uses of information and technology.
Assignments
1. Review the Employer Internship Assessment with your internship work supervisor. Ask him/her to talk to you about
your performance during the internship and to complete the employer assessment. The link to the assessment
will be emailed to them. If you are a NAF student, the internship work supervisor will have 2 assessments to complete.
(See page 17 for a sample of assessment, pages 18 - 20 for the NAF assessment.)
2. Turn in the time sheet for Week 4.
Page 9
Rev. 04-7-21
WEEK 5-TECHNOLOGY
There are many benets of using technology in the workplace. Technology can improve the up-
to-date information and communication resources, increase work performance, and provide a link
to needed resources. Detailed directions and an upload link are provided in the online Internship
course.
Assignment
1. Your job task is to create a PowerPoint/PhotoStory presentation about your Internship experi-
ence. You will be graded on the following:
a. PowerPoint/PhotoStory presentation: content, creativity, grammar and spelling, slide
transitions, clipart and photos
b. You may present this project to your colleagues in the junior class upon your return to
school. This presentation may serve as your rst assignment in your senior Academy
class. Check with your lead teacher once school starts in August for submission and
presentation at your school.
CRITERIA:
Minimum of 15 slides which should include a title and closing slide.
Include a photo of your oce, company, internship supervisor or co-workers and company
logo.
Content: title slide, history of organization, organization chart, duties and responsibilities,
recommendations to future interns, closing slide
Narration: the presentation should be narrated and self-running.
Internship Grading criteria:
Format: In the online course, you will either upload an electronic copy, (you may need
to compress any photos to reduce the size of the le) or upload a link to a “cloud”
storage site, such as “Google, Onedrive, Dropbox, etc.” and send an invite to the In-
structional Supervisor in order to view the le (by email and through the online course
message box.)
DUE DATE:
1. Final project for Internship credit deadline TBA. Submit the project in the online Internship
course. See course lesson for directions.
2. Complete and turn in the time sheet for Week 5. Remember to have your WORK internship
supervisor sign it.
Note: Deadline for submitting FINAL assignments and documents will be given to interns at the begin-
ning of the internship. All documentation must be received by the Instructional Supervisor before the
end of the internship.
Page 10
Rev. 04-7-21
INTERNSHIP ASSIGNMENT CHECK OFF*
Week 1 -RESOURCES PERCENTAGE
Goals, Objectives, Goal-related Activities 10
Timesheet 5
Week 2 –PLANNING AHEAD
Mission, Vision, and Company History 10
Begin taking/collecting photos for PowerPoint/Photostory --
Timesheet 5
Week 3 -REFLECTIONS
Self-Evaluation Form 10
Timesheet 5
Week 4 -ASSESSMENT
Timesheet 5
Week 5 -TECHNOLOGY
PowerPoint/Photostory 45
Timesheet 5
Scale: A=100-90 percent
B=89-80 percent
C=79-70 percent
D=69-60 percent
F=59 percent or less
*The total percentage (50%) will be averaged in with the internship supervisor evaluations (50%) to
determine the nal grade.
Page 11
Rev. 04-7-21
MULTIMEDIA PRESENTATION PROJECT: Internship Powerpoint/Photo Story
CATEGORY 7 5 3 1
Requirements All requirements are
met and exceeded,
such as: minimum
of 15 slides, includ-
ing title and closing
slide; photo and
narration.
All requirements are
met.
One requirement
was not completely
met.
More than one
requirement was not
completely met.
Content Covers topic in-
depth with details
and examples such
as history of organi-
zation, organization
chart.
Includes essential
knowledge about
the topic. Subject
knowledge appears
to be good.
Includes essential
information about
the topic but there
are 1-2 factual
errors.
Content is minimal
OR there are sever-
al factual errors.
Attractiveness Makes excellent
use of font, color,
graphics, eects,
etc. to enhance the
presentation.
Makes good use of
font, color, graph-
ics, eects, etc. to
enhance the pre-
sentation.
Makes use of font,
color, graphics,
eects, etc. but
occasionally these
detract from the pre-
sentation content.
Use of font, color,
graphics, eects
etc. but these often
distract from the
presentation con-
tent.
Organization Content is well
organized using
headings or bulleted
lists to group related
material.
Uses headings
or bulleted lists to
organize, but the
overall organization
of topics awed.
Content is logically
organized for the
most part.
There was no clear
or logical organiza-
tional structure, just
lots of facts.
Mechanics No misspellings or
grammatical errors.
Three of fewer
misspellings and/or
mechanical errors.
Four misspellings
and/or grammatical
errors.
More than 4 errors
in spelling or gram-
mar.
Legend: A=30-35, B=25-29, C=20-24, D=1-19, F=0
Page 12
Rev. 04-7-21
Florida Department of Education
COURSE DESCRIPTION - GRADES 9-12
Subject Area: Experiential Education
Course Number: 8845139-AOHT/ 8815130 – AOF/ 0500300LS – AOIT/ 0500300LS – AOE
Course Title: Hospitality Internship I/ Financial Internship I/ Executive Internship I (Leader-
ship Skills)
Credit: 1.0 credit (high school)
A. Major concepts/content: The purpose of this course is to provide a practical introduction to
the work environment through direct contact with professionals in the community.
The content should include, but not be limited to, the following:
1. Discussion of professional job requirements
2. Building vocabulary appropriate to the area of professional interest
3. Development of decision-making skills
4. Development of personal and educational job-related skills
B. Special note: The nature of this program requires great exibility in the duration of the course
and the number of contact hours. Student performance standards must be designed to meet
the uniqueness of the course.
C. Course Requirements: After successfully completing this course, the student will:
1. Describe educational, personal, and professional requirements of the profession.
2. Understand and use vocabulary appropriate to the profession.
3. Understand special needs unique to a particular profession.
4. Demonstrate knowledge of special technologies.
5. Read literature related to the profession.
6. Exhibit growth in functioning in the adult world and professional community.
7. Use appropriate decision-making techniques in exploring career possibilities.
8. Demonstrate appropriate responsible behavior in various situations.
9. Demonstrate application of academic skills in the performance of the internship respon-
sibilities.
Page 13
Rev. 04-7-21
Florida Department of Education
Internship Training Program
Dual Enrollment Credit – Miami Dade College
Statewide Course: Internships/Practicums/Clinical Practice
MDC Course Number: EGN 1949 Engineering (AOE)
HFT 1949 Hospitality Management (AOHT)
GEB 1949 General Business Finance (AOF)
MAN 1949 Management Internship (AOF)
BSC 1949 Biology Co-op Work Experience 1 (AOHS)
CIS 1949 Computer Science & Computing Technologies (AOIT)
(Minimum 160-hour requirement)
Credit: 3 cr.
Course Descriptions:
Engineering: This is a capstone course designed for students majoring in engineering programs; students will
apply skills and knowledge that they have acquired through their program of study in a real-work environment.
Hospitality Management: Practical application in a clinical setting of knowledge acquired in a classroom related
to lodging, restaurants, travel and tourism; individuals to perform marketing and management functions and tasks
in enterprises engaged in hospitality functions, including lodging services and related event and convention ser-
vices, food and beverage service, and travel and tourism.
General Business: Practical application in a clinical setting of knowledge acquired in the classroom related to
business or administrative policy, international business and nance, small business, social, legal political and
ethical environments of business.
Management Internship: Students will learn to develop practical knowledge and skills in the application of theory
to actual problems in a non-classroom setting in a student’s eld of study.
Biology Co-op Work Experience: Biology Designed to provide training in a student’s eld of study through
worKk experience. Students are graded based on documentation of learning acquired as reported by student and
employer.
Computer Science & Computing Technologies: This course is designed as a work experience for students
majoring in computer information systems programs. Student will apply their skills and knowledge that they have
acquired through their program of study in a real work environment.
Competencies:
Competencies will include but not be limited to knowledge of:
• Workplace goals and structure
• Relevant industry regulations
• Workplace practices and procedures
• Process control in an industrial workplace environment
• Specic skills-sets employed in an industrial workplace environment
• Workplace professionalism
Transfer Status: Not automatically transferable.
Students must meet the Miami Dade College dual enrollment eligibility requirement of having an unweighted 3.0
GPA and certied as college ready in Reading and Writing by passing one of the following tests: PERT, SAT/
ACT, FCAT. Refer to the following link for testing cuto requirements:
http://www.mdc.edu/main/testing/criteria/college_credit_certicate_programs.aspx#fcelptscores
Page 14
Rev. 04-7-21
SUMMER YOUTH INTERNSHIP PROGRAM
SELF – EVALUATION
Student’s Name: _________________________________________________________________________
School Name: ___________________________________________________________________________
Internship Site: __________________________________________________________________________
The questions that follow ask you to evaluate your internship experience over the last ve weeks. Your input in completing this question-
naire will assist us in improving the existing program. Please turn this evaluation in to your Instructional Supervisor with the assignment
for week three.
I. In what career eld did you intern? ______________________________________________
Please use the following rating scale: Strongly Agree 4 • Agree 3 • Disagree 2 • Strongly Disagree 1
II. Evaluate your work environment by writing in the space provided the number that best describes how you feel. Explain the ratio-
nale for any rating other then 4 or 3.
___ 1. Employees in my department understood their job requirements and went about meeting them.
___ 2. I knew the requirements of my internship assignment.
___ 3. Employees in my department cooperated in order to get the job done.
___ 4. Care was taken to insure the work area was pleasant for the employees.
___ 5. My internship assignment gave me a feeling of personal accomplishment.
___ 6. I was able to use my talents and abilities in accomplishing my duties.
III. Evaluate your internship supervisor by writing in the space provided the number that best describes his/her role. Explain the
rationale for any number other then 4 or 3.
___ 1. Ability to motivate employees
___ 2. Ability to delegate authority
___ 3. Ability to solve work-related problems
___ 4. Sense of fairness
___ 5. Ability to communicate eectively with employees
___ 6. Ability to be diplomatic and to provide performance feedback
IV. Use the criteria below to evaluate the overall internship experience.
___ 1. How satised were you with the pre-placement process at your school?
___ 2. How satised are you that your internship assignment broadened your work-related knowledge?
___ 3. How satised were you with your opportunities to learn varied tasks within your department?
___ 4. How satised were you with the information/guidance you received from your Internship Supervisor?
___ 5. How satised were you with the guidance you received from your Instructional Supervisor?
V. Taking everything into consideration, how satised were you with:
___ 1. Your internship assignment?
___ 2. Your work environment?
___ 3. The company you were assigned?
___ 4. The role of your Instructional Supervisor?
___ 5. The internship program?
VI. Answer the following questions:
What are the strengths of the program? ________________________________________________________________
What are the weaknesses of the program? ______________________________________________________________
How can the program be improved? ___________________________________________________________________
Page 15
Rev. 04-7-21
The following Internship Assessment will be completed online by the
Internship Provider to evaluate the student intern’s performance.
Page 16
Rev. 04-7-21
The following Internship Assessment will be completed online in NAFTrack by the
Internship Provider to evaluate the NAF Academy student intern’s performance.
Page 17
Rev. 04-7-21
Page 18
Rev. 04-7-21
Page 19
Rev. 04-7-21
Forms & Instructions
Forms can be completed
online and printed for signature
or
(save le with Adobe Acrobat Pro or
other software)
Page 20
Rev. 04-7-21
2021 Summer Youth Program Internship
For each prepared student to be considered for placement in the 2021 Summer Youth Internship
Program all the forms listed on this document must be completed by MAY 28, 2021, along with
completion of all other requirements: online preparation course completed by May 14th, credit
union account opened by May 28th, see handbook for details.)
This Check-O Sheet must be placed as rst page in pdf le of documents submitted to the Department
of Career and Technical Education by way of the LiveBinder folder. All documents must be uploaded
to the LiveBinder District Online Internship Folder by “Internship Teacher Champion.”
Student Name: ____________________________________ ID #: _______________________
Email: _____________________________ Telephone: _______________________________
School: ___________________________ Academy (if enrolled): _______________________
Student Information Check-o Sheet - Forms Due May 28, 2021
The following documents must be completed and placed into LiveBinder folder by student’s
Internship Champion Teacher, in order for student to be CONSIDERED for an internship; (plus:
online preparation course completion by May 14th, credit union account opened by May 28th.)
INTERNS MUST BE HIRED IN THE MIAMI.GETMYINTERNS.ORG SYSTEM
INSTRUCTIONS and blank copies of forms can be found on following pages of this handbook:
FORMS FOR LIVEBINDER UPLOADED
Summer Youth Internship Program Registration Form
Emergency Student Data Form (FM-2733 Rev. 06-19)
Social Security Verication Form
Proof of School Accident Insurance
Field Trip - Parent Permission Form (FM-2431 Rev. 07-19)
Authorization for Photography/Video
Pre-Internship Course Completion Certicate
Student’s Resume
Student Handbook Acknowledgement Form
Proof of Credit Union Account with SYIP Internship Direct Deposit
enrollment from EdFed – The Educational Federal Credit Union.
Students receive this form from credit union (must contact each year)
Thank you!
NOTE: Only students receiving an email will complete TANF Form (Teachers will not
collect this le)
Hired student interns will submit a W-9 IRS FORM to Internship District Teacher/Supervisor during the rst
week of the summer internship. (Not before internship)
Page 21
Rev. 04-7-21
MIAMI-DADE COUNTY PUBLIC SCHOOLS
SUMMER YOUTH INTERNSHIP PROGRAM (SYIP) REGISTRATION FORM *
STUDENT’S LEGAL NAME _________________________________________________________
(Last, First, Middle)
STUDENT I.D.#___________________________________________________________________
CURRENT SCHOOL ______________________________________ Location # _______________
ACADEMY/CTE PROGRAM ________________________________________________________
INCOMING GRADE FOR FALL TERM ________________________________________________
YEAR(S) OF PREVIOUS PARTICIPATION IN SYIP PROGRAM ____________________________
STUDENT’S ADDRESS ____________________________________________________________
(House Number/Street Name, Apartment #)
_______________________________________________________________________________
(City, State, Zip Code)
STUDENT’S CELL PHONE ________________________________________________________
STUDENT’S E-MAIL ADDRESS _____________________________________________________
DATE OF BIRTH _________________________________________________________________
(Month, Day, Year)
GUARDIAN’S NAME ______________________________________________________________
GUARDIAN’S CELL PHONE _______________________ WORK PHONE ______________________
GUARDIAN’S E-Mail Address _______________________________________________________
DO YOU HAVE INTERNET ACCESS AT HOME TO DO REMOTE WORK: YES ______ NO ______
*Completion of this form does not guarantee placement and enrollment in the
Summer Youth Internship Program.
DO YOU HAVE A DEVICE (COMPUTER, LAPTOP, TABLET, ETC.) TO DO REMOTE WORK? YES ___ NO ___
EMERGENCY STUDENT DATA FORM
FM-2733E Rev. (06-19)
2000611
Parents/guardians have the right to review the professional qualifications of their child's classroom teacher(s) including the licensing status, degree major, graduate degree(s)
and the field of certification. This "right to know", available from your child's school, includes whether your child is receiving services provided by paraprofessionals and, if so,
their qualifications.
Whoever knowingly makes a false statement in writing with the intent to mislead a public servant in the performance of his/her official duty shall be guilty of a misdemeanor of
the second degree under Fla. Stat § 837.06, or whoever makes a false verified declaration is guilty of the crime of perjury, a felony of the third degree, under Fla. Stat. § 95.525,
which are punishable as provided in Fla. Stat., §§ 775.082, 775.083 and 775.084.
The Emergency Student Data Form governs early release withdraw of the student. The registering parent/guardian must sign/verify this form and is responsible for providing
truthful and accurate information. If the student's parents are divorced or separated, the enrolling parent is responsible for providing information that is consistent with the most
recent court order governing such matters as divorce, separation or custody.
School No./Name SectionI.D. No. Grade
Student's Last Name Middle NameFirst NameAPP
Address
Main contact phone number to be used for emergencies and automated messaging:
Registering Parent/Guardian's Name Relation Place of Employment
Telephone Cellphone Email
Non-Registering Parent/Guardian's Name Relation Place of Employment
Telephone Cellphone Email
Is either parent in the Military? Yes ____ No ____ Branch _______________________________________________________
Kindergarten Only: Was the child in pre-school or child care? Yes ______ No ______
Was the full cost paid by you? Yes ____ No ____ What type? Headstart ____ ESE ____ Migrant _____ Other ____ Unknown ____
EMERGENCY CONTACT INFORMATION: I authorize the school district to provide or secure any necessary emergency care for my
child. It is the parent's legal responsibility to assume medical and transportation expenses for your child. In the event that parents of
child cannot be reached, provide contact information below of two persons, by order of priority.
(Phone at Work)(Relation to Student) (Address)(Name)
(Phone at Work)(Relation to Student) (Address)(Name)
PhonePhone Preference of HospitalFamily Doctor
Student health/allergy data which should be known in an emergency:
AUTHORIZATION FOR RELEASE OF STUDENTS FROM SCHOOL: Please provide the names of persons authorized or not
authorized to take your child from school during the school day. Note that persons listed as emergency contacts are not authorized
to pick up your child, unless listed in this section.
Authorized:
Authorized:
Not authorized:
Not authorized:
IT IS THE PARENT'S RESPONSIBILITY to inform the school in person of any changes in the information listed on this form. Under
penalties of perjury, I declare that I have read the foregoing [document] and that the facts stated in it are true.
Date:
Printed Registering Parent/Guardian's Name
Registering Parent/Guardian's Signature
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
Page 22
FORMULARIO DE DATOS DEL ESTUDIANTE PARA UTILIZAR DURANTE EMERGENCIAS
Numero/Nombre de la Escuela _______________________________________________ Número de Identificación. ______________
Grado ________ Sección __________
_________________________________ __________ __________________________ _____________________________
Apellido del estudiante APP Nombre propio Segundo nombre
Dirección
______________________________________________________________________________________________________
Número de contacto telefónico principal que ha de ser ser utilizado en casos de emergencia y mensajes automáticos: ___________________
______________________________________________________ ____________________ ______________________________
Nombre del padre de familia / tutor que matricula Parentesco Lugar de empleo
__________________________ __________________________ ____________________________________________________
Teléfono Teléfono celular Correo electrónico
_______________________________________________________ ___________________ ______________________________
Nombre del padre de familia / tutor que no matricula Parentesco Lugar de empleo
__________________________ __________________________ ____________________________________________________
Teléfono Teléfono Celular Correo electrónico
¿Está alguno de los padres en las fuerzas armadas? Sí _____ No _____ Rama_____________________________
Sólo para estudiantes del Kindergarten: ¿Asistió el niño a una escuela preescolar o a una guardería? Sí ______ No ______
¿Pagó usted todos los gastos? Sí ___ No ___ ¿Qué programa? Head Start ___ ESE ___ Migratorio ___ Otro ___ Lo desconozco
INFORMACION DE CONTACTOS DE EMERGENCIA
: Autorizo al distrito escolar a proporcionar o asegurar cualquier cuidado de
emergencia necesario para mi hijo/a. Es la responsabilidad legal de los padres asumir los gastos médicos y de transporte proporcionados
a su hijo. En el caso de que no se pudiese localizar a ninguno de los padres del niño por favor, proporcione información de contacto de
dos personas, por orden de prioridad, en los espacios que aparecen a continuación.
_________________________ ____________________ _______________________________________ ___________________
(Nombre) Parentesco (Di
rección) Teléfono del trabajo
_________________________ ____________________ _______________________________________ ___________________
(Nombre) Parentesco (Dirección) Teléfono del trabajo
_________________________ _________________ _______________________________________ ___________________
Doctor de cabecera Teléfono Preferencia de hospital Teléfono
Informes acerca de la salud/alergias del estudiante que tienen que ser conocidas en caso de emergencia:
__________________________________________________________________________________________
_______
____________________________________________________________________________
PERMISO PARA QUE EL ESTUDIANTE
SALGA DE LA ESCUELA
:
Por favor, proporcione los nombres de las personas que están
autorizadas o que no están autorizadas para recoger a su hijo durante la jornada escolar. Tome en cuenta que las personas que
aparecen como contactos de emergencia, no están autorizadas para recoger a sus hijos, si sus nombres no aparecen en la lista que se
encuentra a continuación:
Autorizados
: ______________________________ _______________________________ ________________________________
Autorizados: ______________________________ _______________________________ ________________________________
No autorizados: _______________________________ ______________________________ _______________________________
No autorizados: _______________________________ ______________________________ _____
__________________________
ES LA RESPONSABILIDAD DE LOS PADRES informar personalmente a la escuela de cualquier cambio respecto a la información que
se encuentra en este formulario. Declaro bajo pena de perjurio, que he leído lo anterior en este [documento] y que la información que ahí
aparece es verdadera.
Fecha: ________________ Nombre del padre de familia / tutor que matricula en letra de molde: ________________________________
Firma del padre de familia / tutor que matricula: ____________________________________________________________
Los padres de familia/tutores tienen el derecho de revisar las cualificaciones profesionales de los maestros de sus hijos, incluyendo el estatus de la licencia, la especialidad, maestría,
títulos postgrado y el campo de la certificación. La información respecto a este "derecho a saber", está disponible en la escuela de sus hijos, que incluye si sus hijos están recibiendo
servicios prestados por los ayudantes de maestro y de ser así, sus cualificaciones.
El que a sabiendas hace una declaración falsa por escrito con la intención de engañar a un funcionario público en el ejercicio de sus funciones oficiales será culpable de un delito
menor de segundo grado según el Estatuto de la Florida § 837.06, o quien hace una declaración que se verifica que es falsa es culpable del delito de perjurio, un delito grave de
tercer grado, según el Estatuto de la Florida § 92.525, punible conforme a lo dispuesto en los Estatutos de la Florida, §§ 775.082, 775.083 y 775.084.
El Formulario de Datos del Estudiante Para Utilizar Durante Emergencias, rige quién ha de recoger al estudiante de la escuela. El padre de familia / tutor que matricula deberá firmar/
verificar este formulario y es responsable de proporcionar información verdadera y precisa. Si los padres del estudiante están divorciados o separados, el padre que matricula al
estudiante, es responsable de proporcionar información que sea consistente con la orden judicial más reciente que gobierna asuntos tales como el divorcio, la separación o la
custodia.
2000757
FM-2733S Rev. (06-19
)
Page 23
FÒM DONE POU IJANS ELÈV
Èske youn nan paran yo nan Militè? Wi _____ Non _____Branch _________________________________________________________
Jadendanfan Sèlman: Èske timoun nan te nan klas matènèl oubyen gadri? Wi ______ Non ______
Èske se ou ki te peye tout frè a? Wi ___ Non___ Ki kalite?
Headstart ___ ESE ___ Migran ___ Lòt ___ Mwen pa Konnen ___
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
ENFÒMASYON SOU KONTAK IJANS:
Mwen otorize distri lekòl la pou l bay oubyen asire pitit mwen resevwa nenpòt swen ijans li bezwen.
Se responsablite legal paran pou aksepte depans medikal ak transpòtasyon pou pitit yo. Anka nou pa ka kontakte paran timoun nan,
bay enfòmasyon sou kontak de (2) moun anba a, selon lòd priyorite.
_______________________ _________________ _______________________________________ ________________
(Non) (Relasyon ak Elèv la) (Adrès) (Telefòn nan Travay)
_________________________ _________________ _______________________________________ ________________
(Non) (Relasyon ak Elèv la) (Adrès) (Telefòn nan Travay)
_______________
_
_________________ _______________________________________ ________________
Doktè Fanmi an
T
elefòn
Lop
ital Ou Prefere
T
elefòn
Done sou sante/alèji elèv la nou dwe konnen an ka yon ijans:
ͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺͺ_______
__________________________________________________________________________________
FÒM OTORIZASYON POU LAGE ELÈV SOTI NAN LEKÒL LA
:
Silvouplè bay non moun ki otorize oubyen ki pa otorize pou soti ak pitit
ou a lekòl diran jounen lekòl la. Note non moun ki nan lis kontak ijans la pap ka vini chèche pitit ou a lekòl la si non li pa nan seksyon sa a.
Otorize: _______________________________ _______________________________ ________________________________
Otorize: _______________________________ _______________________________ _________________________
_______
Pa otorize: _______________________________ ______________________________ _______________________________
Pa otorize: _______________________________ ______________________________ _______________________________
SE RESPONSABLITE PARAN YO pou enfòme lekòl la an pèsòn nenpòt chanjman nan lis enfòmasyon sou fòm sa a. Anba pinisyon lalwa
pou fosèman, mwen deklare mwen li [dokiman] sa a e fè ki site yo se laverite.
Dat: ___________________ Enprime Non Paran / Gadyen ki Fè Enskripsyon an ___________________________________________
Siyati Paran / Gadyen ki Fè Enskripsyon an: ____________________________________________

Paran/gadyen gen dwa pou revize kalifikasyon pwofesè klas pitit li a (yo) ki gen ladan kondisyon lisans, prensipal karyè, diplòm gradyasyon li, ak matyè sou sètifika li. Dwa
konnen sa a disponib nan lekòl pitit ou a ki gen ladan kèlkeswa pitit ou a ap resevwa sèvis nan men parapwofesyonèl, e si se sa, kalifikasyon yo.
Sepandan si w konnen ou ekri sa ki pa vrè nan entansyon pou twonpe yon sèvant leta nan pèfòme responsablite ofisyèl li yo ap jwenn ou koupab krim dezyèm degre ki pa vyolan
anba lwa f
Stat. § 837.06 , oubyen ou verifye deklarasyon ki pa vrè ou ap koupab krim fosèman, yon zak twazyèm degre, anba lwa Florid Stat. § 92.525 , ki mache ak
pinisyon lwa Florid
Stat., §§ 775.082, 775.083 e 775.084 .
Fòm Done pou Ijans Elèv gouvène lage elèv yo soti lekòl bonè. Paran / Gadyen ki fè enskripsyon an dwe siyen / verifye fòm sa e li responsab pou bay enfòmasyon ki vrè e kòrèk.
Si paran elèv la divòse oubyen separe, paran ki enskri elèv la responsab pou bay enfòmasyon ki konsistan avèk dènye lòd tribinal ki gouvène zafè divòs, separasyon oubyen gadyen
an. 
Nimewo/Non Lekòl_________________________________________ Nimewo I.D. ______________ Ane Eskolè ___ Seksyon _____
_________________________________ __________ __________________________ _____________________________
Non Elèv la
APP
Prenon Lòt Non
Adrès
______________________________________________________________________________________________________
Premye nimewo telefòn pou kontakte pou ijans ak mesaj otomatik: ___________________________
_______________________________________________________ ____________________ ______________________________
Non Paran / Gadyen ki Fè Enskripsyon an Relasyon Andwa Travay
__________________________ __________________________ ____________________________________________________
Telefòn Selilè Adrès Lèt Elektwonik
_______________________________________________________ _____________________ ______________________________
Non Paran / Gadyen ki pa Fè Enskripsyon an Relasyon Andwa Travay
__________________________ __________________________ ____________________________________________________
Telefòn Selilè Adrès Lèt Elektw
onik
2000199
FM-2733H Rev. (06-19
)
Page 24
Rev. 04-7-21
Social Security Verication Form
Date________________
Name of Student – PRINT or type name exactly as printed on Social Security CARD
______________________________________________________
Student ID #: ___________________________________________
School Name: ___________________________________________
The last 4 digits on card: ___________________
I, _______________________________, (print name) verify that the student listed above
has a social security card which I have seen. The card does not state that additional
documentation is needed for work, and therefore indicates that this student is eligible to
work.
__________________________________, Signature (person verifying card)
I am:
_____Internship Teacher Champion
_____ Academy Teacher
_____ Guidance Counselor
_____ School Administrator
_____ M-DCPS District Sta
DO NOT COPY OR SCAN SOCIAL SECURITY CARD
Page 25
Page 26
Rev. 04-7-21
STUDENT ACCIDENT INSURANCE
All students enrolling in the Summer Youth Internship Program must have Voluntary
Student Accident Insurance (Football Insurance is not accepted). The insurance fee is
nonrefundable.
Health insurance that students have on their parents’ or guardians’ plan does not
meet the requirement for Student Accident Insurance.
SIGN UP FOR INSURANCE:
https://www.hsri.com/K12_Enrollment/Main/default.asp
Students who purchase either the At-School coverage or the At-School includ-
ing Athletics & Activities coverage during the school year are covered for the
ENTIRE SUMMER INTERNSHIP PROGRAM even though their ID cards state that
coverage ends on July 31, the expiration date of the current plan year.
(Football Insurance is not accepted.)
Div
ision of Athletics, Activities and Accreditation
MIAMI-DADE COUNTY PUBLIC SCHOOLS
PARENT PERMISSION FORM -- FIELD TRIP
SECTION I. IDENTIFYING INFORMATION
SCHOOL _________________________________________________________________DATE________________________________
STUDENT'S NAME _________________________________________________________I.D. NO. ___________GRADE/HR_________
SECTION II. NOTIFICATION TO PARENT
__________________________________ is planning a field trip for ___________________________ to __________________________
School Group Sponsor Name Name of School Group Destination
The purpose of the trip is __________________________________________________________________________________________
TRANSPORTATION: Private Vehicle ________ Bus ________ Airline ______________________Other____________________________
Name of Carrier Please Specify
This trip will be chaperoned by ____________________________________________ Cost to each student $ ____________________
(Total Number of Chaperones)
DATE(S) OF TRIP :(Include departure/return time) FROM _____________________________ TO _________________________
--The
above time schedule and/or personnel may be changed due to unforeseen circumstances. --
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
SECTION III. PARENT/GUARDIAN'S WRITTEN PERMISSION TO PARTICIPATE IN ACTIVITY
I hereby give permission for my child ___________________________________________ Student I.D. No. _______________________
(Child's Name)
to participate in the field trip to______________________________________________________________________________________
(Destination)
DATE(S) OF TRIP :(Include departure/return time) FROM _____________________________ TO _________________________
I have completed the EMERGENCY CONTACT INFORMATION in Section IV (see below).
SIGNATURE OF PARENT/GUARDIAN _____________________________________________ DATE____________________________
SECTION IV. EMERGENCY CONTACT INFORMATION
FM-4573E Rev. (09-09)
�
Clear Form
FM-2431 (Rev. 07-19)
Field trips are not mandatory. They are designed to enhance curriculum, to encourage student participation in extra-curricular activities, and
to serve as community service projects.
I understand that if I am unable to pay for the cost of this trip, and I want my child to participate, where appropriate, my child will be given an
opportunity to raise funds through authorized fund-raising activities, or be given assistance in identifying another funding source. (This provision does
not apply to activities not directly related to classroom instruction, e.g., Grad Bash, football games, banquets, etc.)
PLEASE KEEP THE TOP PORTION FOR YOUR INFORMATION.
RETURN THE BOTTOM PORTION TO THE TEACHER.
1. Name of parent/guardian ____________________________________________________
2. Parent/Guardian Phone No(s). Home______________________________ Business ___________________________ Cell________________________________
3. In case parent/guardian cannot be reached, please contact:_____________________________ Relationship __________________Telephone No. _________________
4. Please list any insurance policy covering your child ___________________________________________________ Policy No. __________________________________
5. Physician's Name ______________________________________________________________Telephone No. ______________________________________________
5. Only if applicable, complete the following: a. My child has the following medical problem:_____________________________________________________
b. My child takes the following medications regularly:________________________________________________
(Proper Medical form #2702 is on file at the school)
c. My child has the following allergies: ____________________________________________________________
I AUTHORIZE MEDICAL TREATMENT FOR MY CHILD IN CASE OF ACCIDENT OR ILLNESS WHILE ON THE TRIP.
PARENT/GUARDIAN SIGNATURE _______________________________________________________________DATE________________________________________
Page 27
MIAMI-DADE COUNTY PUBLIC SCHOOLS
FORMULARIO DE AUTORIZACION PARA PADRES - EXCURSIONES
SECCION I. DATOS DE IDENTIFICACION
ESCUELA _________________________________________________________________FECHA______________________________
NOMBRE DEL (DE LA) ESTUDIANTE_______________________________NO. DE IDENTIFICACION ___________GRADO_________
SECCION II. NOTIFICACION A LOS PADRES
__________________________________ planea una excursión con __________________________ a __________________________
Nombre del(de la) patrocinador(a) (Nombre del Grupo) (Destino)
El propósito de la excursión es______________________________________________________________________________________
TRANSPORTE: Vehículo Privado ________ ómnibus ________ Aerolínea_____________________Otro__________________________
(Nombre de la compañía) (Por favor, especifique)
Esta excursión será supervisada por ________________________________________ Costo por estudiante $ ____________________
(Numero de Chaperones)
FECHA:(Incluir hora de salida y llegada) DE _____________________________ A ___________________________
-- E
l horario o el personal pueden ser cambiados por circunstancias imprevistas --
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
SECCION III. AUTORIZACION DE PADRES/TUTORES PARA QUE EL (LA) ESTUDIANTE PARTICIPE EN LA EXCURSION
Le doy la autorización para que mi hijo(a) ______________________________________ No. de Identificación _____________________
Nombre del (de la) niño(a)
participe en la excursión a _________________________________________________________________________________________
Destino
FECHA:(Incluir hora de salida y llegada) DE _____________________________ A ___________________________
He llenado los datos SOBRE A QUIEN LLAMAR EN CASO DE EMERGENCIA de la Sección IV (a continuación).
FIRMA DEL PADRE/DE LA MADRE O TUTOR(A) ___________________________________ FECHA____________________________
SECCION IV. DATOS SOBRE A QUIEN LLAMAR EN CASO DE EMERGENCIA
FM-4573E Rev. (09-09)
�
Clear Form
FM-2431 (Rev. 07-19)
Las excursiones no son obligatorias. Las mismas son planificadas a fin de realzar el programa de estudios, alentar la
participación de los estudiantes en actividades extracurriculares y servir como proyectos de servicios a la comunidad.
Entiendo que si deseo que mi hijo(a) participe y no puedo pagar el costo de esta excursión, cuando sea posible, a mi hijo(a) se le dará la oportunidad
de recaudar fondos mediante actividades de recolección de fondos o se le asistirá en la identificación de otras fuentes de recursos financieros (Esta
medida no se aplica a las actividades que no se relacionen directamente con la instrucción que se realiza en las aulas, como por ejemplo, la noche de
los graduados o “Grad Bash”, los juegos de fútbol y los banquetes, etc.)
PARA QUE SE MANTEGA INFORMADO(A) POR FAVOR CONSERVE LA PORCION SUPERIOR
POR FAVOR DEVUELVA LA PORCION INFERIOR A LA ESCUELA
1. Nombre del padre/de la madre o tutor(a) _______________________________________________________________
2. No. de teléfono del padre/de la madre o tutor(a) Casa_____________________ Empleo ________________________ Celular____________________________
3. Si los padres o tutor(a) no pueden ser localizados, por favor comuníquense con_________________ Relación________________No. de teléfono_________________
4. Póliza(s) de seguro que cubren a su hijo(a) _____________________________________________________ No. de Póliza(s) _______________________________
5. Nombre del médico _________________________________________________________ No. de teléfono _______________________________________________
5. Llene lo siguiente solamente si aplica a su hijo(a): a. Mi hijo(a) tiene el siguiente problema médico:___________________________________________________
b. Mi hijo(a) toma las siguientes medicinas con regularidad:__________________________________________
(El correspondiente formulario medico 2702 está archivado en la escuela)
c. Mi hijo(a) tiene las siguientes alergias: _________________________________________________________
AUTORIZO A QUE SE DE TRATAMIENTO MEDICO A MI HIJO(A) EN CASO DE ACCIDENTE O ENFERMEDAD MIENTRA SE ENCUENTRE EN ESTE VIAJE
FIRMA DEL PADRE/DE LA MADRE O TUTOR(A)___________________________________________________FECHA________________________________________
Page 28
MIAMI-DADE COUNTY PUBLIC SCHOOLS
FÒM PÈMISYON - PWOMNAD
SEKSYON I. IDANTIFYE ENFÒMASYON
LEKOL ____________________________________________________________________DAT________________________________
NON ELÈV LA_______________________________________________ NO. I.D. ___________NIVO ANE ESKOLÈ/ÈD TAN _________
SEKSYON II. NOTIFIKASYON POU PARAN
__________________________________ iap planitye yon pwornnad pou __________________________ Pon_____________________
Pwofesè/non pahvonè GwouplSijè Destination
Bi pwomnad sa a se _____________________________________________________________________________________________
TRANSPÒTASYON: Machin Prive ________ Bis _________ Avyon ___________________________Lòt__________________________
Non Konpayi Espesifye
Pwomnad sa a ap gen siveyan A chapewon__________________________________________ L ap koute chak timoun______________
(Pwofesè/ParanlToude - endike konbyen)
Dat N ap Derape _________________________________ Dat N ap Retounen _______________________________________
--
Le ki make anwo a e/oubyen moun yo kab chanje akoz yon sikonstans enprevi--
--
--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
SEKSYON III. PÈMISYON PARAN/GADYEN A LEIKRI POU PATISIEPE NAN AKTIVITE
Mwen bay pèrnisyon pou pitit mwen ______________________________________ No. I.D. ___________________________________
(ATon Timoun nan)
patisipe nan pwomnad____________________________________________________________________________________________
(Destination)
Dat N ap Derape _________________________________ Dat N ap Retounen _______________________________________
Mwen ranpli ENFÒMASYON KONTAK IJANS la nan Seksyon IV (wè anba a).
SIYATI PARAN/GADYEN ____________________________________________________ DAT_________________________________
SEKSYON IV. ENFÒMASYON KONTAK IJANS
FM-4573E Rev. (09-09)
�
Clear Form
FM-2431 (Rev. 07-19)
Pwomnad pa obligatwa. Yo fèt pou amelyore kourikouloum nan, pou ankouraje elèv yo patisipe nan ekstra aktivite
akadernik, e pou sèvi kòm pwojè.
sèvis korninotè.
Mwen konprann si rn pa ka peye pou pwornnad sa a, e mwen vle pitit mwen patisipe, lè li apwopriye, n ap otri pitit mwen an opòtinite
pou li kolekte lajan atravè aktivite pou kolekte ton lekòl la otorize, oubyen nan bay asistans nan idantitye lòt sous pou fon. (rezèvasyon
sa a pap aplike pou aktivite ki pa dirèkteman relate ak enstriksyon klas, pa egzanp, sware gradyasyon, jwèt foutbòl, bankè, eks.)
SILVOUPLÈ KENBE POSYON ANWO A POU ENFÒMASYON.
RETOUNEN POSYON ANBA A BAY PWOFESÈ A.
1. Non paran/gadyen ________________________________________________________________
2. No. Telefòn paran/Gadyen (yo) Kay: ___________________________ Biznis ________________________ telefòn celulair ____________________________
3. An ka nou pa ka jwenn paran/gadyen an, silvouplè kontakte ____________________ Relasyon ak elèv la ______________ No. Telefòn_______________
4. Silvouplè site nenpòt asirans ki kouvri pitit on _______________________________________________ No. Kontra___________________________________
5. Non dokte li____________________________________________________________________ No. Telefòn ____________________________________________
5. Ranpli hy ki suiv yo, sèlsi yo aplikab: a. Pitit mwen an gen pwoblèm medikal sa yo: _________________________________________________
b. Pitit mwen an pran medikaman sa yo regilyèrnan: ___________________________________________
(Bonjan fòm medikal #FM-2702 nan dokiman lekòl la)
c. Pitit mwen an gen alèji sa yo: _____________________________________________________________
M OTORIZE TRETMAN MEDIKAL POU PITIT MWEN AN KA AKSIDAN OUBYEN MALADI PANDAN Ll NAN PWOMNAD LA.
SIYATI PARAN/GADYEN ______________________________________________________________________ DAT______________________________________
Page 29
Page 30
Rev. 04-7-21
AUTHORIZATION FOR PHOTOGRAPHY/VIDEO
I, ____________________________________________________, the parent or guardian of
_________________________________________ hereby authorize and give consent to
service providers and the staff of The Children’s Trust of Miami-Dade County, Career Source
South Florida, Miami-Dade County, EdFed – The Educational Federal Credit Union and
Miami-Dade County Public Schools as follows:
I hereby:
consent and authorize or do not consent and authorize
the staff of The Children’s Trust of Miami-Dade County, Career Source South Florida, Miami
-Dade County, EdFed – The Educational Federal Credit Union and Miami-Dade County
Public Schools to take/use still photographs, digital photographs, motion pictures, television
transmission, and/or videotaped recordings (hereinafter “Recordings”) of me, my children, or
my wards for educational, research, documentary, and public relations purposes.
________________________________
Signature of Parent or Guardian
_________________________________
Date
Any such Recordings may reveal your identity through the image itself without any
compensation to you, your children or wards.
Any and all Recordings taken of you, your children or wards shall be the sole property of The
Children’s Trust.
With regard to the use of any Recordings taken of you, your children or wards, you hereby
waive any and all present and future claims you may have against The Children’s Trust
of Miami-Dade County, Career Source South Florida, Miami Dade County, EdFed – The
Educational Federal Credit Union and Miami-Dade County Public Schools their staff, service
providers, employees, agents, affiliates and Board members.
Page 31
Rev. 04-7-21
AUTORIZACION PARA FOTOGRAFIA/VIDEO
Yo, ______________________________________________, el padre o guardián del niño/a
__________________________________autorizo y doy por este medio consentimiento a
los proveedores de servicios y al personal de El Fidecomiso de los Niños (The Children’s
Trust) del condado Miami-Dade, Career Source South Florida, Miami-Dade County, EdFed –
The Educational Federal Credit Union y Miami-Dade County Public Schools como sigue:
Otorgo permiso y autorizo - o - No otorgo permiso ni autorizo
al personal de El Fidecomiso de los Niños (The Children’s Trust) del condado Miami-Dade,
Career Source South Florida, Miami-Dade County, EdFed – The Educational Federal Credit
Union y Miami-Dade County Public Schools a tomar y a usar fotografías corrientes, fotografías
digitales, películas, transmisiones de televisión, y/o a hacer grabaciones de mí, de mis niños, o
de mis estancias con fines educativos, de investigación, documentales, y con el propósito de
relaciones públicas.
________________________________
Firma del Padre o Guardián
_________________________________
Fecha
Cualquier grabación puede revelar su identidad a través de la imagen por sí misma, sin esperar
ninguna remuneración para usted, sus niños o sus estancias.
Cualquiera y todas las grabaciones tomadas de usted serán sólo propiedad del Fideicomiso de
Los Niños.
Con respecto al uso de cualquier grabación tomada de usted, de sus niños o de sus estancias,
renuncia por este medio a cualesquiera y a todas las demandas presentes y futuras que pueda
tener contra El Fidecomiso de los Niños (The Children’s Trust) del condado Miami-Dade, Career
Source South Florida, Miami-Dade County, EdFed – The Educational Federal Credit Union y
Miami-Dade County Public Schools su personal, los proveedores de servicios, empleados,
agen-tes afiliados y miembros de La Junta Directiva.
Page 32
Rev. 04-7-21
OTORIZASYON POU DWA FOTOM/VIDEO
Mwen,_______________________________________________, paran oswa gadien
__________________________________, bay òganizasyon kap rand sevis ak anplwaye “The
Children’s Trust” nan arondisman Miami Dade, Career Source South Florida, Miami-Dade
County, EdFed – The Educational Federal Credit Union and Miami-Dade County Public
Schools otori-sasyon ak konsantman-m pou sak suiv la:
Mwen:
dakò ak otorize oswa pa dakò ak pa otorize
Bay anplwaye “The Children’s Trust” nan arondisman Miami Dade, Career Source South Florida,
Miami-Dade County, EdFed – The Educational Federal Credit Union and Miami-Dade County
Public Schools konsantman-m ak pemisyon-m pou yo ka pran foto-m, foto pitit-mwen ak tout
fanmi-m ou byen foto digital, épi filmé pwogram televisyon ak/oswa imaj video (yo rele “Anregis-
treman”) pou yo ka itilize yo nan nenpot ki kalite fòm pwomosyon kankou: edukasyon, rechèch,
dokumantè, sit intenet ou byen relasyon piblik ak réklam.
________________________________
Signati Paran oswa Gadien
_________________________________
Date
Nenpot anregistreman ki bay idantite-w, san yo pa peye ni mwen, ni pitit mwen, ak ni lot fanmi-m.
Nenpot ak tout enregistreman-m, de pitit mwen, ak fanmi-m ap toujou rete pwopriyete “The Chil-
dren’s Trust” la.
Mwen renonse dwa-m pou m mande anplwaye “The Children’s Trust” nan arondisman Miami
Dade, Career Source South Florida, Miami-Dade County, EdFed – The Educational Federal
Credit Union and Miami-Dade County Public Schools ansam ak ajan li, anplwaye li, sèvite li ak
manb direkte nenpot reklamasyon sou itilizasyon anregistreman sa yo sou kelkswa fòm.
Page 33
Rev. 04-7-21
CERTIFICATE OF COMPLETION
This form is printed out by the student at the end of the Internship Preparation Course.
Teacher should vertify that the student has completed the course; sign the certicate; scan
and upload to LiveBinder folder.
SAMPLE
Page 34
Rev. 04-7-21
2021 SUMMER YOUTH INTERNSHIP PROGRAM
STUDENT HANDBOOK ACKNOWLEDGEMENT
The 2021 Summer Youth Internship Program is designed to give students real-life experiences in the
world of work. During this time, students will take on the roles and responsibilities of a valued member
of a business organization. It is important that the student interns understand that dress, punctuality,
attendance, and behavior reects upon themselves and their parents, teachers, school, and peers. Ac-
tions speak louder than words and are remembered longer. As young professionals, it is important that
the impression left is bright, like a star.
The Internship involves two individuals to oversee the intern; an internship workplace supervisor and a
Miami-Dade County Public Schools (M-DCPS) Internship Supervisor. The M-DCPS Internship Super-
visor’s position is to oversee the internship, to visit interns and internship providers, and to assist in a
successful internship. This individual may or may not be the intern’s lead teacher, but is there to help with
the challenges that may arise. Please call or e-mail the M-DCPS Instructional Supervisor if there are any
questions or concerns.
This handbook has been developed to help you prepare and successfully complete the 2021 Summer
Youth Internship Program. It contains activities, suggestions, and resources to assist in the completion
of weekly assignments. It is the intern’s responsibility to read this handbook and understand what will be
asked of them. If there are any questions about assignments or activities, please discuss them with
the M-DCPS Instructional Supervisor.
Enjoy your summer internship experience and remember your supervisors are here to help and support.
If there are any questions, problems, concerns, or issues that arise, contact them for input and direction.
Remember the 3P’s: positive, polite and punctual. Good Luck.
I, _________________________ understand that it is my responsibility to read this handbook and clarify any items.
PRINT NAME
I further understand that I will be held accountable for all information contained in this handbook.
_____________________________________________________________________________
SIGNATURE DATE SCHOOL
Miami Dade County Public Schools
Department of Career & Technical Education
10151 NW 19th Ave
Miami, FL 33147
Phone 305-693-3030 Fax 305-696-9346
Internship Hotline 305-693-3005
Page 35
Rev. 04-7-21
SYEP 2012
TANF SYEP ELIGIBILITY/SCREENING
Summer Youth Employment Program
Youth’s Name:
SSN:
If no SSN, was proof of SSN application provided?
YES
NO
N/A
Is the youth a United States Citizen?
YES
NO
If no, is the youth a Qualified Non-Citizen?
YES NO N/A
DEMOGRAPHIC INFORMATION
Family Size:
Date of Birth: / /
Age:
Sex:
M
F
Street address:
City:
State:
ZIP Code:
Phone Number: ( )
Alternate Number: ( )
ELIGIBILITY
Purpose 1:
Assist needy families so that children can be cared for in their homes
Yes
No
Eligibility Criteria:
In a family receiving Temporary Cash Assistance
Residing in the home of a parent
Residing in the home of a caretaker
Documentation: Florida Screens Required
AIHH AIID AIIM ARDT IQCH
Purpose 2:
Reduce the dependency of needy parents by promoting job preparation, work, and marriage
Yes No
Eligibility Criteria:
Youth’s family income does not exceed 200% of the Federal Poverty Level
Documentation: Check all that apply
Tax Returns Pay Stubs (last 4 weeks) Employment Verification Form
Unemployment Benefits Free/Reduced Lunch Other: SSI/SSDI, Child Support
2012 Federal Poverty Level-200%
Persons In Family/Household
Poverty Guideline
Persons In Family/Household
Poverty Guideline
1
$22,340
5
$54,020
2
$30,260
6
$61,940
3
$38,180
7
$69,860
4
$46,100
8
$77,780
Note: For families/households with more than 8 persons, add $3,960 for each additional person
PRIVACY ACT STATEMENT
_____I understand that I am required by law to provide my social security number(s) or proof that I have applied for a social security
number if I do not currently have one to receive TANF funded services. This is mandatory under the Social Security Act, section 1137. The
SSN is used to administer the program and associate all services, correspondence and participation with the appropriate individual.
_____I understand that i
f I do not have a SSN and I do not know how to apply for one, that I can request help from the One-Stop Career
Center or other program provider.
_____I understand th
at my SSN will be used to associate all records to my identification, including program participation and the receipt of
benefits/services.
Parent/Guardian Signature: ________________________________Date: ______________
RWB Designee: ____________________________ Phone Number: ( ) ______________
RWB Signature: __________________________________________ Date: ______________
An equal opportunity employer/program. Auxiliary aids and services are available upon request to individuals with disabilities. All voice
telephone numbers on this document may be reached by persons using TTY/TDD equipment via the Florida Relay Service at 711
NOTE: Only students receiving an email will complete TANF Form (Teachers will not collect this file)
Page 36
Rev. 04-7-21
Instructions for Completing TANF SYEP Eligibility / Screening Form
Summer Youth Employment Program
1. Youth’s Name – Enter the youth’s name as it appear on the social
security card.
2. SSN – Enter the youth’s SSN #, a copy of the SSN card is required
3. If no SSN was proof of SSN application provided – The SSN
application will not be acceptable. If the youth does not have a
physical SSN card the parent need to go to the Social Security
Administration (SSA) office and apply for a replacement card. It
usually takes about 2-3 weeks to receive the replacement card.
4. Is the youth a United Citizen: - The answer is based on the
information that was submitted to you from the youth
5. If no, is the youth a qualified non-citizen? - Answer this question
If the answer for #4 was no.
Demographic Information
Complete the Demographic Information section of the form based on
the documentation that is provided.
Eligibility
If the youth is receiving free / reduced lunch / reduced lunch, Purpose 2
will be yes.
Documentation is needed for each youth that is receiving free /
reduced lunch
Privacy Act Statement
The rst and the third statement of the Privacy Act Statement which is pertaining to the youth
Social Security Number need to be initialed.
Parent/Guardian Signature and Date need to be complete by the youth parent or guardian.
RWB signature will be signed by M-DCPS sta.
NOTE: Only students receiving an email will complete TANF Form (Teachers will not
collect this le)
.
THE OFFICIAL FINANCIAL INSTITUTION OF SYIP
2021
SUMMER YOUTH INTERNSHIP PROGRAM
IMPORTANT: Please follow these steps to open your account at EdFed – The Educational Federal Credit Union. If
you do not complete your application by the May 28th deadline, you may experience a delay in being paid.
1. Wha
t do I need to open my account with EdFed?
A minimum deposit of $5 (this will be automatically debited from your first deposit to activate your account).
Copy or digital photo of Student’s Social Security card
Copy or digital photo of government-is
sued, unexpired form of identification such as:
Driver's License, State Identification, Passport/Passport Card, or Resident Alien Card
Proof of physical address, if not listed on identific
ation (verification is acceptable via student’s MDCPS portal)
Your Mother’s Maiden Name (mother’s last name at birth)
Student's School ID Number
2. Ho
w do I open my account with EdFed?
a) Go to www.edfed.org/2021internship and complete the Membership Application (Refer to Membership
Application Resource Guide for assistance filling it out)
b) Sign the application using either a pen, stylus, mouse, or touch pad (must be an original signature; cannot be
a typed or template signature)
c) Once you have completed and signed the application, you will need to follow the Secure Email Resource
Guide to send the application along with copies of your Social Security card, government-issued identification,
and/or proof of physical address to EdFed via our secure email system.
3. When will I receive my Account, ATM or Debit Card information?
Usually within 7-10 business days after your account has been successfully opened. .
4. How can I access my accounts?
Once you have money in your account, you can make FREE withdrawals at any Publix ATM or an EdFed branch
drive-thru. You can use most any ATM machine, but most other ATMs will charge a fee.
5. What should I d
o with the Internship Direct Deposit Form in my new account packet that I received in the
mail?
Give the form to your lead/champion t
each
er no later than May 28, 2021 or your payroll may be delayed.
6. What if I lost my Internship Direct Deposit Form?
You can contact EdFed via email at syipaccounts@edfed.org, and a staff member will be glad to assist you in
getting the form.
7. W
ha
t happens if I miss the account opening deadline?
Your paycheck may be delayed until the next scheduled pay day.
8. Who do I contact if I have questions regarding internship assignments, internship placements or payroll?
Career & Technical Education (CTE) at: 305-693-3005, internship@dadeschools.net
or visit
ww
w.ctemiami.net/internships-2021/
9. Wh
o
do I contact to find out if my account has been opened or for the status of my ATM/Debit card?
EdFed at: 305-270-5239 or via email at syipaccounts@edfed.org
Page 37
Rev. 04-7-21
March 22, 2021
Dear Parent/Guardian:
Your child has been selected to participate in the 2021 Miami-Dade County Public Schools’ (M-DCPS) Summer
Youth Internship Program. M-DCPS’ Department of Career and Technical Education office and EdFed – The
Educational Federal Credit Union have partnered to offer your child the opportunity to open a savings and/or
checking account. This will enable your child to have their internship compensation (stipend) automatically
deposited into his/her own savings account.
EdFed is a great place for your child to begin his/her financial future because of higher dividends on savings
accounts and a continued commitment to financial education. EdFed has been helping educators and their
families achieve financial success since 1935, and is proud to provide a dependable financial resource for your
children today.
In addition, as a parent/guardian of an M-DCPS student, you are eligible for membership with EdFed where you
can take advantage of their many deposit and loan products.
If you have questions, please call (305) 270-5239 or visit www.edfed.org/studentservices.
Sincerely,
Name of Principal
Page 38
Rev. 04-7-21
SCHOOL NAME: ___________________________________________________
MIAMI-DADE COUNTY PUBLIC SCHOOLS
Summer Youth Internship Program
Internship Provider, Instructional Supervisor, Student and Parent Responsibilities
Internship programs are planned to develop students academically, economically and socially. There are responsibilities to the school, to the
community and to the business sponsors that must be considered when accepting students into these programs.
Internship Provider Responsibilities
The internship provider agrees to place the student intern in his/her business organization, including remotely, for the purpose of providing workplace
readiness experience. The internship will be under the supervision of a qualified supervisor. The work will be performed under safe and hazard free
conditions. The student will receive the same consideration given to employees with regard to safety, health, general working conditions, and other
policies and procedures of the business. This includes but is not limited to all local, state and federal guidelines that related to working conditions in
light of the COVID-19 pandemic. The internship provider will adhere to all state and federal policies related to nondiscrimination in employment and
educational programs or activities with regards to race, gender, color, religion, ethnic or national origin, political beliefs, marital status, age, sexual
orientation, social and family background, linguistic preferences or disabilities. All Federal and Florida Child Labor Laws must be adhered to and are
available for review in the Student and Employer Handbook or at www.myfloridalicense.com. I understand that the required dates of
attendance will take place during the approved SYIP 2021 term and that NO vacation is allowed during this time frame. The internship provider
agrees to adopt a background screening process that is consistent with M-DCPS guidelines at a minimum on the person(s) who will be supervising
the student. The internship provider understands and agrees that it is subject to all applicable federal and Florida laws and School Board
policies relating to the confidentiality of student records. Time sheets are a legal document and any falsification will be considered fraud.
The Student agrees to comply with all requirements found in the Student Internship Handbook:
1. Adhere to rules and regulations of the business and act in an ethical matter;
2. Provide his/her own transportation to place of internship;
3. Inform the internship provider and the instructional supervisor in the event of illness or emergency that prevents attendance;
4. If attending the internship in-person, comply with all state and federal guidelines on social distancing, proper hygiene, and illness prevention, including by
wearing a facial covering when appropriate;
5. Be in attendance (no more than 2 unexcused absences) and punctual on the job and for all specified meetings, including those conducted remotely;
6. Not voluntarily quit/resign a job without previous authorization from the internship provider and the instructional supervisor; and
7. Understand that M-DCPS is the recognized authority for making any adjustments or changes in the internship program. This principle applies regardless
of whether or not the student obtained his/her own internship position.
The Internship Supervisor agrees to:
1. Hold a minimum of two conferences with the internship provider to discuss the student’s progress;
2. Communicate with internship provider to resolve any interference that may occur between the internship program and the company’s policies;
3. If supervising the internship in-person, comply with all state and federal guidelines on social distancing, proper hygiene, and illness prevention, including
by wearing a facial covering when appropriate;
4. Counsel the student about the work-based learning experience.
The Parent (Guardian) agrees to:
1. Ensure that their child follows internship provider/school expectations of the program;
2. Support the policy of requiring the student to complete the length of the internship program. Internship providers should not be put in a position of having
to accommodate the vacation schedule of their intern’s family.
3. Understand that the student is responsible for his/her own transportation;
4. Understand that Miami-Dade County, Miami-Dade County Public Schools (M-DCPS), CareerSource South Florida, The Children’s Trust and/or the
Foundation for New Education Initiatives, Inc. will not be held liable in case of accident/injury on the way to and from internship. Student must obtain M-
DCPS Student Accident Insurance to be eligible for the program.
5. Release Miami-Dade County, Miami-Dade County Public Schools (M-DCPS), CareerSource South Florida, The Children’s Trust and/or the Foundation for
New Education Initiatives, Inc. from any and all claims arising out my child’s participation in the program.
6. Allow Miami-Dade County Public Schools to share my child’s relevant educational records with Miami-Dade County; CareerSource South Florida; EdFed –
The Educational Federal Credit Union; The Children’s Trust; and/or the Foundation for New Educational Initiatives, Inc. in accordance with the program
requirements.
We, the undersigned, agree that we have read and understand the purpose and intent of the Internship Program Responsibilities.
_________________________________________ _________________________________ _______________________
Student Name (print) Student Signature Date
_________________________________________ _________________________________ _______________________
Parent Name (print) Parent Signature Date
_________________________________________ _________________________________ _______________________
Internship Supervisor (Print) Internship Supervisor Signature Date
_________________________________________ _________________________________ _______________________
Internship Provider Supervisor (Print) Internship Provider Supervisor Signature Date
Lupe Ferran Diaz, Ph.D., Executive Director______ _________________________________ _______________________
Department of Career and Technical Education Signature Date
The School Board Attorney’s Office approved this agreement as to form and legal sufficiency.
Copy with original signatures will be collected DURING the internship. Must be signed by all parties.
Do not fill out this form. Sample only
will be give out to students after the
internship begins.
Page 39
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