Qualtrics Survey | Qualtrics Experience Management

The purpose of this form is to screen potential internship agencies suitable for student internships for the Department of Recreation, Parks and Tourism at Radford University. If the agency is approved, it will be included on the approved agency list. The agency’s name, location, and website will be listed.

Agency Name

Location City

State

Web Address

Are you currently affiliated with other college and internship programs?

No
Yes

What type of internships do you offer? Select all that apply.

Outdoor Recreation and Leadership
Recreation Therapy
Tourism and Special Events
Parks and Recreation

When can students do their internships at your agency? Select all that apply.

Fall
Spring
Summer

How many interns do you typically accept during a semester or summer?

We require our students to complete a 14-week/560-hour internship. Can you meet this requirement?

No
Yes

Please provide a brief overview of programs and services your agency provides.

Please list the primary population(s) you serve.

Would the intern have the opportunity to complete a special project which is required by our agency?

No
Yes

On average, what percentage of time will the intern participate in the following activities? (Total should be 100)

Administrative Duties
Meetings
Special Projects or Events
Supervisory Duties
Maintenance
Assessment/Screening
Recreation Programming
Recreation Education
Clerical Duties
Facilitation
Marketing
Customer Service
Other
Total

Does your agency/department have a designated staff member responsible for coordinating internship experiences?

No
Yes

If your agency does not have a designated staff member, how do you coordinate the intern's experience?

If a Recreation Therapy setting, please provide the CTRS qualification number(s) and name(s) of your CTRS on staff.

Does your agency compensate the intern in any way for the internship?

No
Yes

If yes, please explain how you compensate the intern (e.g., stipend, salary, housing, reimbursements).

Name of the person completing this form.

Title or Position

Phone Number

Email Address

If applicable, name of the student requesting you complete this form.

We encourage you to register with Handshake if you would like to recruit Radford University students for internships and employment. Handshake is facilitated by Radford’s Center for Career and Talent Development. Radford students use Handshake as the primary resource to search for internships and employment. Please access the following URL and register with Handshake.

https://www.radford.edu/content/career-services/home/employers/handshake.html

Thank you for completing this survey. If you have any questions, contact our Internship Supervisor, Dr. Susan Van Patten at svanpatt@radford.edu.

Please be sure to hit the submit button (arrow) below to submit your form.