ࡱ> k Ybjbj:: @XubXub` 4666h4T66(&&&&&Z< n6p6p6p6p6p6p6$9;6ZZ6&&46R R R F&&n6R n6R R J-|.&`+IU-Z6606-s<s<$..Ts<0DR 666s< B : PRACTICUM AGREEMENT ӣƵ School of Library and Information Science Date: Please attach a list of anticipated or planned tasks and activities the student will be working on or participating in during the course of the practicum. This list will form the functional basis for this agreement. The following is the contact information for the student, practicum site supervisor, and faculty practicum advisor. The signatures indicate agreement with the practicum design and evaluation. Student and practicum on-site supervisor should sign this agreement and send to [insert your name]. Student Name: Signature: Phone: Email: Practicum On-Site Supervisor Name: Position: Signature: Phone: Email: Faculty Practicum Advisor: Signature: _________________________________________________________ Practicum site supervisors may cancel this agreement at any time should the student fail to comply with the agreed upon tasks, activities and learning goals. ӣƵ School of Library and Information Science encourages practicum on-site supervisors to contact the faculty practicum advisor if a problem is developing. AGREEMENT FOR EXPERIENTIAL EDUCATION SCHOOL OF LIBRARY AND INFORMATION SCIENCE This agreement made and entered into this [DATE] by and between, [FACILITY NAME, ADDRESS], hereinafter known as the "Facility," and the University of Southern Mississippi, hereinafter referred to as "Program". It is agreed by the aforesaid parties to be of mutual interest and advantage for selected students, hereinafter known as "School of Library and Information Science," of the aforesaid indicated Program to be provided quality experiences at the Facility. It is further agreed by the aforesaid parties that: I. MUTUAL RESPONSIBILITIES A. The Facility will accept Library and Information Science students selected by the Program for a period of experiential education. Experiences shall be arranged by the Program and the facility representative so that the stated philosophy and objectives of the Program and the Facility are met. The number of Library and Information Science Students assigned will be subject to the availability of the Facility personnel for teaching and supervising. The rules and regulations of the Facility shall be applicable to the assigned Library and Information Science Student(s). D. The Program maintains the privilege to visit the Facility before, after and/or during experiential education period. The Program will consider suggestions from the Facility's personnel regarding curriculum improvement. II. PROGRAM RESPONSIBILITIES The Program shall: reserve the right to revise any Library and Information Science Student assignment when participating in the experiential education program. B. provide the evaluation forms and other forms necessary for experiential education. C. reserve the right to withdraw a Library and Information Science Student from his/her assigned experiential education experience at the Facility when in the Program's judgment the experience does not meet the needs of the Library and Information Science Student. not discriminate against any Library and Information Science Student or applicant for enrollment on its course of study because of race, creed, color, religion, sex, disability or national origin. III. FACILITY RESPONSIBILITIES The Facility shall: A. provide the physical facilities and equipment necessary for the experiential education experience. B. designate the director of the Facility or his/her designee to be the liaison representative to the Program. C. reserve the right to request the Program to withdraw a Library and Information Science Student from his/her assigned experiential education experience when his/her performance is unsatisfactory or his/her behavior is disruptive or detrimental to the Facility and/or the persons it serves. D. provide appropriate orientation material to the Library and Information Science Student and Program. E. hold the University harmless in any resulting litigation from either service recipient or student related claims. IV. LIBRARY AND INFORMATION SCIENCE STUDENT RESPONSIBILITIES A. be responsible for obtaining his/her own professional liability insurance, via billing to their university student account. B. have the responsibility of transportation to and from the Facility and on any special assignment by the Facility. C. be responsible for all emergency room and other medical expenses for treatment of on-the-job incurred injuries. D. be responsible for following the administrative policies of the Facility. be responsible for reporting to the designated individual at the Facility on time. V. GENERAL AGREEMENT The term of this agreement shall begin on ______ and terminate on _______. B. It is understood and agreed that the parties hereto may revise or modify this agreement by written amendment wherever the same shall be agreed upon. C. Both parties reserve the right to terminate the agreement with thirty days written notice. SIGNED: __________________________________ By: Dr. Gordon Cannon, Provostand Senior Vice President for Academic Affairs [Practicum Supervisor and address] This document shall be executed in duplicate originals. Either duplicate or a photocopy thereof shall be valid and enforceable.      ӣƵ College of Education & Human Sciences School of Library and Information Science College of Education and Human Sciences Revised 1/18/2023  ӣƵ College of Education & Human Sciences School of Library and Information Science College of Education and Human Sciences Revised: 1/18/2023 ӣƵ College of Education & Human Sciences School of Library and Information Science EdefkW Y i j k l n F H K  9 ĸ|ph`ZT hCJ h >CJhNCJaJhCJaJ *h:hCJaJ *h:hpCJaJ# *h:hpCJOJQJ^JaJ# *h:h >CJOJQJ^JaJ *h:h >CJaJ *hphpCJaJhpCJaJ *h >h >CJaJhN5CJaJh >h >5CJaJh >CJaJh >5CJ\aJ efmnG H l n }  H I J K gdgd >gd >$a$gd >   " # ) * 8 9 : H J R S T <FLPo-7V`ISr1PC]@Vr|/ºޙޙޙލޙޅ~ޙ h(8hOh0IhtOhNh-h -h_hl hrhU hrh*]M hOhhr *hrhr hOhU hOh` h(8h` h(8hNT h(8hh(8h5 hN5 htO5h(8hCJ1 DE1]^^gd & Fgd ^`gd & Fgd `0^`0gd`gdgdgd $ Ha$gdtO^>?\]pqXYbc()^gd & Fgd^gd & Fgd`gd ^`gd & Fgdgd 0^`0gd/9Xv/HlvFe¾·~vrh *hE0h hNmh' hNmh hOh hOh]:o hOhO hNmhO *hNmhX hNmhX hNmhUh@ hNmh@ hNmh hhh(8haJhy hN5h(8h5 h(8hhNh_,)IJ^_;<`bABN 0^`0gd`gd `0^`0gd`gdgdEF  0^`0gd & Fgd  !gd^gd & Fgd`gd`gdgd 12PQRV]ºwlaVh(8hw,CJaJh(8h<~CJaJh(8hq%CJaJh(8h'LCJOJQJaJh:htO h(8h'hD~oh$htOhtO\ h,\hch5A5hch'5hchd5 *h[;}hU hU5h~JCJaJho2hU\ hUhUho2hUCJaJhhU h(8hU 2QRnykd$$Iflz t 6 0644 lae4p yto2$& #$/Ifb$gdo2gds$& #$/Ifb$gdo2ykd$$Iflz t 6 0644 lae4p yto2]_`b{vqlqggd}gd`gdgd.gd'LgdykdZ$$Iflz t 6 0644 lae4p yto2 ]_`acdfgijlmnɱyqf]TLh_~%h_~%6hS6mH sH h_~%6mH sH h~dhTmH sH hNmH sH htOmH sH hqyCh8mH sH hqyCmH sH h8mH sH h8 hsOJQJaJhmHnHu/jhshLOJQJUaJhmHnHuhWjhWU h(8hc! 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