Frostburg State UniversityExercise & Sport Science

Health Fitness Concentration

Internship Packet

Table of Contents

Introduction p. 3Guidelines for Internship Experience p. 4Internship Assignment Sheet p. 7Requirements for the Promotional Project/Marketing Plan p. 9Requirements for the Individual Fitness Program p. 12Requirements for the Group Program p. 13Requirements for Testing Portfolio p. 15Grading of Field Experience p. 16Time-Line p. 22Appendix I: Health Fitness Internship Application p. 28Appendix II: Student Evaluation: Mid-Term p. 23Appendix III: Student Evaluation: Final p. 30Appendix IV: Sample Daily Journal Form p. 32Appendix V: Internship Site Articulation Agreement / Contract p. 35

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Frostburg State UniversityExercise & Sport Science

Health Fitness Focus

Internship ExperiencePHEC 495: 9 Credits

Introduction

The purpose of the internship is to provide a means for applying theoretical concepts learned in the undergraduate Exercise & Sport Science Curriculum to a practical situation. This experience is an opportunity for you to learn to effectively deliver health and fitness concepts to target populations. During this experience you will have the opportunity to enhance your knowledge of health and fitness, but also to learn about the business aspect of health and fitness management.

During the internship you should think of yourself as a professional. You are representing yourself as well as Frostburg State University. You will get out of this experience as much as you put into it. Remember that internship experiences can, (and often do) lead to future employment.

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Guidelines For Internship Experience: Health & Fitness Concentration

Prior to Internship: (1) All potential interns must register for PHEC 495 for 9 credits.(2) All potential interns must hand in a list of a minimum of three potential sites where they would like to do their internship ONE SEMESTER PRIOR TO THE INTERNSHIP EXPERIENCE! The internship coordinator in cooperation with the student intern will make the final decision as to where the student will be placed.(3) The APPLICATION FORMS must be completed and handed in to the coordinator___________________________________ two (2) months prior to the internship experience.(4) All course work in the health/fitness concentration must be completed. You must print a copy of PAWS ACADEMIC AUDIT form and submit it with application. This requirement is to ensure that you have all necessary knowledge, skills, and abilities to successfully complete all required duties during your experience.(5) You must become a student member in a health/fitness related professional organization. Please select from the following: You are required to provide evidence of membership (i.e. membership card) prior to beginning your internship

o National Strength & Conditioning Association (NSCA) www.nsca-lift.org

o American College of Sports Medicine (ACSM) www.acsm.org

o American Council on Exercise (ACE) www.acefitness.org

o Aerobic & Fitness Association of America (AFAA) www.afaa.com

(6) You MUST obtain professional liability insurance prior to beginning your internship experience. This insurance will be provided free of charge through Frostburg State University. You must submit your internship application by the due date (see the internship time-line) to allow for adequate processing time for your policy. Failure to submit your application in a timely manner will result in you being de-registered from PHEC 495.

(7) You must purchase a current copy of the ACSM’s Guidelines For Exercise Testing and Prescription.

(8) You must contact the internship site and arrange for an intake interview with the supervising staff member(s). You should provide the facility with a current

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resume as well as a list of your personal goals and expectations from this experience. You should also provide the internship site’s supervising staff member(s) with a copy of your Evaluation & Prescription (PHEC 411) Exercise Testing Portfolio.

(8) You must provide the internship-site with a copy of the articulation agreement / contract (Appendix V). This agreement MUST be completed and returned to the following address PRIOR to beginning the internship experience. Failure to complete and return this agreement in a timely manner will result in you being de-registered from your internship course!

Return contract to your advisor: John Wright, Hunter Brakeall, Michele Bennett, or Melody Kentrus

Evidence verifying that all of the above requirements have been met MUST be presented to the PHEC 495 FACULTY no later than two months prior to the beginning of the internship experience (unless otherwise specified). Failure to fulfill all minimum requirements will result in the student NOT being allowed to participate in the Internship experience for that semester.

Internship Requirements: (1) You must complete a minimum of 45 hours on the job for each credit that you

are registered for. This will equal 405 total hours, or approximately 30 hours per week during a typical semester. All hours must be logged and then verified by your direct supervisor.

(2) You must keep a daily log of all activities that will be handed into the internship coordinator following the internship. This log should include specific assignments and activities carried out each day of the internship.

(3) You must fulfill all internship basic requirements (i.e. special projects, fitness testing, program development, special populations). See “Internship Assignment” sheet.

(4) You must inform PHEC 495 FACULTY as to your scheduled workdays. You must submit prior to beginning your experience a proposed work schedule to the PHEC 495 FACULTY.

(5) You MUST contact the PHEC 495 FACULTY at least once per week throughout the internship to report your progress as well as any difficulties that you are experiencing. The preferred method of contact is via e-mail through the FSU system.

Post-Internship Requirements: (1) You must meet with the PHEC 495 FACULTY to discuss your internship. All materials required for completion of the internship must be turned in to the PHEC 495 FACULTY immediately following the internship. This includes:

Professional Resume Evidence of membership in a professional organization

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Evidence of personal liability insurance Daily Log Business Plan Promotional Project / Marketing Plan Individual Fitness Program Group Fitness/Wellness Program Testing Portfolio Summary reflection paper.

All materials must be organized in a professional portfolio.

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Internship Assignment Sheet

The internship experience is graded Pass /Fail. In order to obtain a passing grade a minimum score of 70% must be earned during the internship.

During the Internship experience the student will be required to complete several projects designed to enhance their educational experience. These projects will be kept in a student portfolio and must include:

A business plan. A promotional project / marketing plan for the internship facility. An individual fitness program. A group fitness / wellness program (i.e. an exercise class, educational

seminar, or team program). A fitness-testing portfolio. A summary reflection paper.

Grade Components:

Faculty Evaluation 10%A completed application form for the internship must be in the Internship Coordinator’s office two months prior to the internship

Daily Log: 5% A comprehensive account of what you did during your hours of duty should

be recorded in this log. Included in this account you should document:o Date & hours workedo What I did todayo Something I learnedo What I did wello What I need to work on

You must use the supplied internship daily log forms (appendix IV) for documenting all hours and activities. Failure to provide a complete journal will result in failure of the internship.

You must have your supervisor sign-off on your daily journal every day to verify completion of daily responsibilities.

Projects: (see individual requirements on following pages) Group Project 10% Marketing Plan 10% Individual Fitness Program 30% Fitness Testing Portfolio 20% Summary / Reflection Paper 3%

An evaluation paper detailing your experiences on the job should include the following:

o What did you accomplish during the internship?

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o What do you see as your strengths and weaknesses in this field?

o Were there any educational weaknesses in your Exercise & Sport Science major which hindered your performance in this internship? Please be very specific in detailing both strengths and weaknesses.

o Your suggestions for improving your education leading up to this internship and for improving this particular program.

Evaluation Forms 10% Evaluation forms completed by the internship site supervising staff member

should be sent to the student’s internship coordinator at mid-term of the internship and immediately following the internship.

o Mid-Term evaluation formo Final Evaluation form

Coordinators Evaluation & Discussion Forums 10% This evaluation will be based on the material handed in by the intern and a

total evaluation of the entire experience. It includes your participation in weekly discussion forums on Blackboard as well as your weekly communication with your internship coordinator/FSU instructor.

In the event of you being “fired” from your internship due to unprofessional behavior, rules violations, or criminal activity, you will

receive a grade of “Fail” for your internship experience. Appeals will be granted to allow you to present your side of the story as well as any evidence

that you may have in your defense.

If you are unable to complete your internship due to events out of your control (i.e. the company goes out of business, layoffs, budget-cuts, act of God, etc.),

you must contact the PHEC 495 FACULTY immediately to arrange for alternative internship opportunities. All possible efforts will be made to place you in a new internship site as quickly as possible. If this is not possible, then you will be graded based on the work that you have completed up to the point

of termination.

* See “Grading of Internship” form for specific criteria.

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Requirements for the Promotional Project/Marketing Plan

As a health fitness professional you will be expected to effectively design programs and then MARKET your program to attract potential participants. Marketing of your program will involve performing a brief feasibility study, determine your target population, contacting your target population, budgeting and determining successful and cost-effective means of advertising your program.

It will be your responsibility to market your group wellness activity in order to attract participants. You will be responsible for working with your internship facility’s marketing/advertising department to develop and implement a successful marketing strategy.

Develop a marketing plan for the business by answering these questions. If you are working at a franchise facility (Gold’s Gym, World Gym, Bally’s, etc.) you will have to use the marketing strategy the franchiser has developed. Your marketing plan should be included in your business plan and contain answers to the questions outlined below.

o 1. Description of business – Services? Products? Size of business? o 2. Who are your customers? Define your target market(s).o 3. Are your markets growing? steady? declining? o 4. Is your market share growing? steady? declining? o 5. If a franchise, how is your market segmented? o 6. Are your markets large enough to expand? o 7. How will you attract, hold, increase your market share? If a franchise, will

the franchiser provide assistance in this area? Based on the franchiser's strategy? How will you promote your sales?

o 8. What pricing strategy have you devised?

MARKETING PLAN

This is the marketing plan of____________________________ I. MARKET ANALYSISA. Target Market - Who are the customers?

o 1. We will be selling primarily to (check all that apply): o Total Percent of Business

a. Private sector _______ ______

b. Wholesalers _______ ______

c. Retailers _______ ______

d. Government _______ ______

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e. Other _______ ______

o 2. We will be targeting customers by: o a. Product line/services.

We will target specific lines ________________

b. Geographic area? Which areas? ________________

c. Sales? We will target sales of ________________

d. Industry? Our target industry is ________________

e. Other? ________________

o 3. How much will our selected market spend on our type of product or service this coming year?

$________________

B. Competitiono 1. Who are our competitors?

NAME ________________________________________

ADDRESS _________________________________________

_________________________________________

Years in Business ___________________

Market Share ___________________

Price/Strategy ___________________

Product/Service

Features ___________________

NAME _________________________________________

ADDRESS _________________________________________

_________________________________________

Years in Business ____________________

Market Share ____________________

Price/Strategy ____________________

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Product/Service

Features ____________________

o 2. How competitive is the market?

High ____________________

Medium ____________________

Low ____________________

o 3. List below your strengths and weaknesses compared to your competition (consider such areas as location, size of resources, reputation, services, personnel, etc.):

Strengths Weaknesses

1._______________________ 1._____________________

2._______________________ 2._____________________

3._______________________ 3._____________________

4._______________________ 4._____________________

C. Environmento 1. The following are some important economic factors that will affect our

product or service (such as trade area growth, industry health, economic trends, taxes, rising energy prices, etc.):

________________________________________________

________________________________________________

________________________________________________

o 2. The following are some important legal factors that will affect our market:

________________________________________________

________________________________________________

________________________________________________

o 3. The following are some important government factors:

________________________________________________

________________________________________________

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________________________________________________

o 4. The following are other environmental factors that will affect our market, but over which we have no control:

________________________________________________

________________________________________________

I attest that the student-intern completed this marketing analysis with the assistance of the General Manager / Marketing Coordinator / Fitness Director / Business Manager (or other acceptable personnel). Internship Site Supervisor’s Signature:_______________________________________________

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Requirements for the Individual Fitness Program

Applying accumulated knowledge and developing an effective fitness program for an individual is the cornerstone to a Health Fitness Instructor’s career. After completing the core curriculum of the Health Fitness concentration you will have the knowledge, skills, and abilities to effectively assess, evaluate, and prescribe a comprehensive fitness program for a variety of individuals. This project will allow you the opportunity to demonstrate your skill as a fitness professional by designing a personal fitness program for a facility member and serving as their “personal trainer” for the duration of your internship.

Requirements for successful completion of the Individualized Fitness Program are as follows:

Assessment Section Comprehensive wellness / health assessment Body composition analysis Musculoskeletal Flexibility Assessment Cardiovascular Fitness Assessment Blood Pressure Measurement and assessment Musculoskeletal strength assessment for ALL exercises performed. Diet Analysis using Dine Healthy, Cengage Learning, Diet Analysis, or other

approved software

Design Section Needs analysis

Biomechanical analysis Bioenergetics Injury analysis Other factors (previous injuries, etc.)

Goal Assessment 1-RM Predictions (all strength exercises) Periodization Model- with dates, starting ASAP while you are there with the

client Metabolic Equations / Heart-rate predictions (cardiovascular exercise)

Fitness Program Section Strength Program: 1 macrocycle (one year) Cardiovascular Program: (one year) Flexibility program Nutrition / weight-loss program

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Requirements for the Group Program

Health fitness professionals are frequently required to design and lead group wellness activities. These activities range in scope from simple aerobics classes to smoking cessation or diabetes management programs. It will therefore be your responsibility to design and implement a comprehensive group activity within the context of your sponsoring facility. The topic for this program should be decided between your facility supervisor and yourself. Suggested topics for this group intervention are as follows:

o Diabetes managemento Smoking Cessationo Hypertension Managemento Exercise for chronic pain / fibromyalgiao Pre/Post natal exerciseo Senior fitnesso Osteoporosis preventiono Youth / Adolescent Fitnesso Training for Competitiono Group Cyclingo Progressive relaxationo Yogao Martial Artso Sport Specific Trainingo Adventure trainingo Water Exerciseo Flexibility Training

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Requirements for Testing Portfolio

To ensure that you have an opportunity to adequately practice your fitness component testing, you will be required to complete a fitness-testing portfolio during your internship experience. The required components of this portfolio are as follows:

Health Risk Appraisal (PAR-Q and informed consent): 30 Body Composition Tests: 100

o Skin-fold: at least 50o Any combination of the following tests: Infrared (futrex), BIA,

Hydrostatic weighing, Bod-Pod. Musculoskeletal flexibility: 50 total

o Sit & Reacho Apley’s Scratch Testo Goniometry

Strength Tests:o Predicted 1-RM: 25o Actual 1-RM: 25

Blood Pressure: 100 Cardiovascular Tests (must include informed consent for each participant):

30o YMCA Cycle Testo Step Testo Lifecycle Fit Test: (Must be completed w/ exercise B.P.)

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Your final portfolio:- Should be in a 3-ring binder or book with a professional coil binding, including

labeled tabs for each section.- It must be submitted in the order as is laid out on the grading sheet . - Everything should be typed with the exception of your daily journal. Horizontal

pages should be facing the same direction, outward. - You only should have one page per sleeve, visible front and back, not multiple

pages that need to be removed. - Keep in mind that you shouldn’t be working on writing or putting together your

portfolio during internship hours.- For all paperwork, you may use forms that your site uses, or you may create your

own forms. You should not be using FSU’s class forms. Due dates:Group project approval: Wednesday at noon of Week 3Individual approval: Wednesday at noon of Week 3 Marketing approval: Wednesday at noon of Week 5Midterm evaluation: Wednesday at noon of Week 6Final portfolio: Wednesday at noon of Week 13

GRADING OF INTERNSHIP

DAILY LOG & SUMMARYIn detail and not the same thing everyday

Criteria Met

Date and hours worked /2What I did today /2Something I learned /2What I did well /2What I need to work on /2Summary of your experience —1/2 – 1 page

- Where you were and what your main job responsibilities were/2

Value = 5% /12

Name: ______________________________________Semester: ___________________________________

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GROUP PROJECTFACULTY approval due Wednesday at noon of WEEK 3

Criteria Met

Typed, 1.5 spaced, 12 pt font, ½ to 1 page summary defining details of your program BEFORE completing it /2FSU Faculty approval – if via email you must print email and add to portfolio /2Evidence of scholarly activity directly related to the research and implementation of group project (3 scholarly articles with abstracts printed and submitted with your own summary of them)

/2

Typed, 1.5 spaced, 12 pt font, ½ to 1 page summary defining details of your program AFTER completing it, with reflection about when it was completed, who attended, how it went, and what you could have done differently

/2

Supervisor (on-site) signature including date of completion /2Value = 10% /10

MARKETING PLANFACULTY approval due Wednesday at noon of WEEK 5

Criteria Met

Typed, 1.5 spaced, 12 pt font, ½ to 1 page summary defining details of your program BEFORE completing it, including target market and what you plan to market- either the facility or a program within the facility

/2

FSU Faculty approval – if via email you must print email and add to portfolio /2SWOT analysis for implementation of your wellness program/class /2Evidence of marketing of plan within the facility and / or community (marketing materials included, power point, brochure, copy of advertisement, pictures etc.)

/2

Typed, 1.5 spaced, 12 pt font, ½ to 1 page summary defining details of your plan AFTER completing it, with reflection about how it went and what you could have done differently

/2

Supervisor (on-site) signature including date of completion /2Value = 10% /12

INDIVIDUAL FITNESS PROGRAMFACULTY approval due Wednesday at noon of WEEK 3

Criteria Met

Typed, 1.5 spaced, 12 pt font, ½ to 1 page summary defining details of your program and your client

/1

FSU Faculty approval – if via email you must print email and add to portfolio /1Assessment Section Health history form /1 Par Q & informed consent /1 Medical Clearance Form Waived with signature of client

OR Submitted to physician for signature and date with evidence of completion

/1

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prior to activity if client had any “yes” answers on PAR-Q Body composition analysis

- Method used (if skinfold, include numbers for each body part) /2- Body mass/weight /2- % fat vs % lean mass and actual numbers /2- Ideal weight

o Must be the client’s ideal weight, in line with goals, and healthy and attainable for the client

/2

- Interpretation/assessment (ultra lean, lean, overweight, obese, etc.) /2 Musculoskeletal Flexibility

- Method used (include measurements for each trial) /2- Interpretation/assessment (poor, fair, good, excellent, etc.) /2

Cardiovascular Fitness - Resting HR /2- Maximum HR - Show work and calculation used

/2

- Target HR (using Karvonen formula at 5 various percentages)- Show work and calculation used

/2

- VO2 max- Show work and calculation used

/2

Blood Pressure (mmHg)- Measurement /2- Interpretation/assessment /2

Musculoskeletal strength for the following (minimum one of each) - Describe the tests used- Upper body measurement /2- Upper body interpretation/assessment (show work) /2- Lower body measurement /2- Lower body interpretation/assessment (show work) /2- Core strength measurement /2- Core strength interpretation/assessment (show work) /2

Diet Analysis - 3 day initial food journal - In detail with portion sizes

/5

- Includes software printout using Dine Healthy, Cengage Learning, Diet Analysis, or other approved software

- Includes normative values

/5

- Interpretation/assessment of software printout- What foods do you recommend?- What can your client do to improve his or her diet?

/5

Design Section Needs analysis

- Biomechanical analysis /5- Bioenergetics /2- Injury analysis /2

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- Other factors (previous injuries, etc.) /1 Goal Assessment

- Be specific. You will need to discuss accomplishing these in the summary you write. Any weight goals should match ideal weight

- Includes short term and long term goals

/5

1-RM Predictions and Actual 1 – RM for ALL strength exercises prescribed /5 Periodization Model—with dates, starting ASAP while you are there with the

client/15

Metabolic Equations / Heart-rate predictions (minimum of 5 predicted HRs) using Karvonen formula (cardiovascular exercise)

/5

Fitness Program Section Must be in line with clients specific goals and consider under and overtraining Strength Program: 1 macrocycle (one year)

- List actual weight for each exercise, not just percentages- Weights need to be less than the client’s max

/15

Cardiovascular Program: (one year) - With appropriate Heart Rates- Should line up with bioenergetics assessment

/10

Flexibility program: (one year)- Consider dynamic & static flexibility- Describe FITT

/10

Nutrition / weight-loss program: for each cycle of one year program- Detailed pre and post workout

/10

Typed, 1.5 spaced, 12 pt font, ½ to 1 page summary defining details of your program AFTER completion, with reflection on how it went and what you could have done differently.

/2

Supervisor (on-site) signature including date of completion /2Value =30% /147

TESTING PORTFOLIOCriteria

MetCharts must be numbered with every chart and every page to include a heading /1Include testing protocols and /2Include normative values for assessments /2Body Composition Tests: 100

- Include your assessment in addition to the % and poundso Skin-fold: at least 50 /10o Assess any combination of the following tests: Infrared (futrex), BIA,

Hydrostatic weighing, Bod-Pod./10

Musculoskeletal flexibility: 50 total- Write all 3 scores and indicate the median with each test- Include assessment of each test

/10

o Sit & Reacho Apley’s Scratch Test

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o GoniometryStrength Tests:

o Predicted 1-RM: 25- Choose 1 formula to calculate predicted max- Must show your work for credit

/15

o Actual 1-RM: 25 /15Blood Pressure: 100

- Include assessment and recommendations for the client/10

Cardiovascular Tests: 30 (any combination of any of the following tests is acceptable unless previous approval of another test is granted by the internship coordinator). MUST include signed informed consent and PAR-Q for each.

/15

o YMCA Cycle Testo Queens College Step Testo Lifecycle Fit Test: (Must be completed w/ exercise B.P.)

Value = 20% /90

SUMMARY/REFLECTION PAPERCriteria

MetDid you accomplish your goals? /2What were your personal strengths & weaknesses? /2Did your academic coursework prepare you professionally for the internship? /2What improvements would you suggest in the academic coursework to prepare you better?

/2

Value = 3% /8

EVALUATION FORMS- You should give your supervisor the evaluations at least a week in

advance.- You should provide the envelope to your supervisor and have him/her seal

and sign the back of the envelope

Criteria Met

Mid-term: ________% DUE WEEK 6 WEDNESDAY AT NOON /10Final: ________% DUE WITH YOUR PORTFOLIO WEEK 13 AT NOON /10 Value = 10% /20

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FACULTY EVALUATIONCriteria

MetPrior to Internship

- Submit application by due date in previous semester /2- Attend internship meeting previous semester /2- Copy of 1st Aid & CPR card /2

During Internship- Weekly Blackboard discussions with classmates /10- Weekly check-in emails with your assigned faculty instructor /10- ACSM Guidelines book receipt /1- Proof of Professional Membership (ACSM, NSCA, etc) /1- Information printed of certification you plan on completing (CPT, PES,

CSCS)/1

- Final resume—updated with internship experience /1- One choreographed GROUP EXERCISE class /1

General Guidelines- Materials are typed, well-written w/ appropriate citations /1- Proper sentencing and grammar /1- Materials are submitted in by DEADLINES /1- Materials reflect application of professional knowledge and disposition /1- Contact information for after graduation /1

Value = 12% /36

90%-100% = A, 80%-89% = B, 70%-79% = C, 60%-69% = D, ≤ 59% = FDecimals will only be carried to 10ths. Rounding up will occur with any 100th value of 5 or higher.

Final Grade: ___________________ / _____________________

__________%

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INTERNSHIP PHEC495Time-Line

Application Due Date: Date of Internship: Application Due date: Fall Semester: May 1st

Spring Semester: December 1stSummer Session: May 1st

Winter Session: October 1st

List of three potential internship sites: Due with application. Interviews w/ 2 potential internship sites: Must be completed prior to

application due date. Evidence of these two interviews must be presented with the application (i.e. letter from internship site, business card w/ supervisor’s signature, etc.). Evidence must be turned in with application.

Final Decision regarding the internship site: Due with application. Evidence of professional membership : 1st day of classes-internship

semester. Evidence of liability insurance: 1st day of classes-internship semester. Work Schedule with all pertinent contact information: 1st week of

classes-internship semester. Faculty Contact : Minimum of once per week, in person, email or on

phone. Daily hour log : Must be signed on a daily basis by site supervisor. –

Failure to have supervisor sign each day’s log will result in that day’s hours not counting toward the 405-hour requirement.

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Appendix I

DEPARTMENT OF KINESIOLOGY & RECREATIONHEALTH FITNESS INTERNSHIP

CONTACT INFORMATION

Students: Print out 2 copies of this form, complete the information, & sign the contract after discussion with your potential supervisor. Give one copy to your supervisor at your chosen site. Return one to your instructor at FSU by November 30th, 2017.

Student Name: _________________________________________________________________ GPA: _______________________

Phone number: _________________________________________________________ Class standing: __________________

E-mail address: _______________________________________________________________________________________________

When I graduate from FSU, I want to: __________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

Previous FE placements: __________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

Site Name: __________________________________________________________________________________________________________________

Address: __________________________________________________________________________________________________________________

__________________________________________________________________________________________________________________

Phone Number: ______________________________________________________________ Ext: __________________________

Supervisor’s Name: _________________________________________________________________________________________

E-mail: __________________________________________________________________________________________________________________

Phone Number: __________________________________________________________________________________________________________________

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Description of the Facility: ____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

Your role at that facility as a student: ____________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________

Student Signature: ____________________________________________________________________________________________________________________

Supervisor Signature: ____________________________________________________________________________________________________________________

Date: ______________________________

Name_____________________________________________________ Birth Date________________________

Mailing address _________________________________________________________________________________________________

_________________________________________________________________________________________________

Permanent Address _________________________________________________________________________________________________

_________________________________________________________________________________________________

Telephone ____________________________________________Major: __________________________________________________________Expected Graduation Date_________________Grade Point Average (major) ____________ Grade Point Average (overall) _______________Total Semester Hours Completed______________Car: ( ) yes ( ) no

What professional clubs or organizations are you currently a member of?___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What offices have you held and what honors have you received in high school and college?__________________________________________________________________________________________________________________________________________________________________________________________________

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What job experiences relate to your internship placement?____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

What would you like to accomplish during your internship? List goals and objectives.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

List your strengths and weaknesses as you presently perceive them related to completing an internship.STRENGTHS:_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________WEAKNESSES:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Give a brief biographical sketch. Include what influenced and motivated you to pursue this career path. Explain what contributions you can make to the Health/Fitness field. Why did you choose the Health/Fitness concentration? _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Define professionalism and teamwork. How does this relate to your philosophy of Health/Fitness?_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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List three different topic areas for a special project.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

Attach a copy of your professional resume and your course audit to this application form detailing all courses and grades received for those courses throughout your college career. This course audit can be obtained from your advisor, the registrar, or on Paws.

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Questions/ Requirements for potential Internship Sites

Is the facility a certified fitness/ wellness center?

_________________________________________________________________________________________________________

What degree does my potential supervisor have?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Does my supervisor/ anyone you will be working with have any specific certifications? (CSCS, NSCA, SCCC, AFPA, etc.)

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

What is your potential supervisor’s favorite part of working at this facility?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

What would my daily tasks and duties consist of at this facility?

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

_________________________________________________________________________________________________________

Who will you work with most closely?

_________________________________________________________________________________________________________

Are there enough clientele for you to be able to complete my tests needed (minimum of 100).

_________________________________________________________________________________________________________

Can I complete 405 hours during the semester (30-35 hours/week) at this facility?

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______________________________________________________________________________

Appendix II

STUDENT EVALUATION: MID-TERM

Internship PHEC 495

Student Intern______________________________ Date_______________________

Internship Site Supervisor_____________________Agency_____________________

Instructions: Using the criteria listed below, please evaluate the performance of the student during the internship. This form should be returned to the Internship Coordinator:

John Wright, Hunter Brakeall, Michele Bennett, or Melody Kentrus

Personal Qualities Poor Fair Good Excellent N/APersonal AppearanceEnthusiasmCooperativenessCourtesyRapport w/ ParticipantsRapport w/ Staff

Professional Qualities Poor Fair Good Excellent N/ADependabilityDaily PreparationInitiativeReceptiveness to Criticism

Knowledge Poor Fair Good Excellent N/AAnatomyBiomechanicsExercise PhysiologyHuman Development and AgingPathophysiology and Risk FactorsHuman Behavior and PsychologyHealth Appraisal and Fitness TestingSafety and Injury PreventionExercise ProgrammingNutrition and Weight Management

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Program Administration/ManagementElectrocardiography

Skills Poor Fair Good Excellent N/ARisk Factor IdentificationBlood Pressure MeasurementBody Composition MeasurementTreadmill / Bike UseFlexibility TestingStrength TestingElectrocardiogram (ECG) PreparationECG AdministrationECG ReadingExercise PrescriptionExercise LeadershipVerbal Communication to a GroupIndividual CounselingWritten Communication

Overall Performance

Unsatisfactory 1 2 3 4 5 Outstanding

Please list any skills which this student needs to improve and/or include any additional comments here or on the other side of this form.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

This evaluation has been discussed with the student: ( ) yes; ( ) no Recommendation for employment: ( ) yes; ( ) no

Internship Site Supervisor: _______________________________ Date: _____________

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Appendix III

STUDENT EVALUATION: FINAL

Internship PHEC 495

Student Intern______________________________ Date_______________________

Internship Site Supervisor_____________________Agency_____________________

Instructions: Using the criteria listed below, please evaluate the performance of the student during the internship. This form should be returned to the Internship Coordinator:

John Wright, Hunter Brakeall, Michele Bennett, or Melody Kentrus

Personal Qualities Poor Fair Good Excellent N/APersonal AppearanceEnthusiasmCooperativenessCourtesyRapport w/ ParticipantsRapport w/ Staff

Professional Qualities Poor Fair Good Excellent N/ADependabilityDaily PreparationInitiativeReceptiveness to Criticism

Knowledge Poor Fair Good Excellent N/AAnatomyBiomechanicsExercise PhysiologyHuman Development and AgingPathophysiology and Risk FactorsHuman Behavior and PsychologyHealth Appraisal and Fitness TestingSafety and Injury PreventionExercise ProgrammingNutrition and Weight ManagementProgram

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Administration/ManagementElectrocardiography

Skills Poor Fair Good Excellent N/ARisk Factor IdentificationBlood Pressure MeasurementBody Composition MeasurementTreadmill / Bike UseFlexibility TestingStrength TestingElectrocardiogram (ECG) PreparationECG AdministrationECG ReadingExercise PrescriptionExercise LeadershipVerbal Communication to a GroupIndividual CounselingWritten Communication

Overall Performance

Unsatisfactory 1 2 3 4 5 Outstanding

Please list any skills which this student needs to improve and/or include any additional comments here or on the other side of this form.________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

This evaluation has been discussed with the student: ( ) yes; ( ) no Recommendation for employment: ( ) yes; ( ) no

Internship Site Supervisor: _______________________________ Date: _____________

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Appendix IV

Sample Daily Journal FormName: _______________________ Internship Site: _____________________

1. Date:________________________ Daily Hours:_______________________Total Accumulated Hours: ____________

What I did today:

Something I learned:

What I did well:

What I need to work on:

Supervisor signature: Date:

2. Date:________________________ Daily Hours:_______________________Total Accumulated Hours: ____________

What I did today:

Something I learned:

What I did well:

What I need to work on:

Supervisor signature: Date:

Appendix IV

Frostburg State University

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Exercise & Sport Science: Health Fitness ConcentrationCooperating Site Internship Agreement & Contract

The purpose of the internship is to provide a means for applying theoretical concepts learned in the undergraduate Exercise & Sport Science Curriculum to a practical situation. This experience is an opportunity for the student to learn to effectively deliver health and fitness concepts to target populations. During this experience the student will have the opportunity to experience and enhance their knowledge of health & fitness, but also to learn about the business aspect of health & fitness management. The supervising internship site plays a vital role in the professional preparation of the intern. Frequently, the internship site is the student’s first exposure to the professional world. In order to ensure a quality experience for both the student-intern and for the supervising internship site expectations and responsibilities will be outlined for all participating persons.

Student-Intern Responsibilities:During their professional placement in an internship facility, the student intern

will be responsible for fulfilling the following requirements:(1) The intern must complete a minimum of 45 hours on the job for each credit that they are registered for. This will equal 405 total hours, or approximately 30 hours per week during a typical semester. All hours must be logged and then verified by the direct supervisor.(2) The intern must keep a daily log of all activities that will be handed into the program coordinator following the internship. This log should include specific assignments and activities carried out each day of the internship.(3) The intern must fulfill all internship basic requirements (i.e. special projects, fitness testing, program development, special populations). (4) The intern must inform the PHEC 495 FACULTY as to the scheduled workdays.(5) The intern must contact the PHEC 495 FACULTY several times throughout the internship to report your progress as well as any difficulties that they are experiencing.(6) During the internship experience the student will be required to complete several projects designed to enhance their educational experience. These projects will be kept in a student portfolio and must include:

A promotional project / marketing plan for the internship facility. An individual fitness program. A group fitness / wellness program (i.e. an exercise class, educational

seminar, or team program). A fitness-testing portfolio. A summary reflection paper.

Responsibilities of the Sponsoring Internship Site

The supervising internship site shall provide the FSU Exercise & Sport Science Intern with the opportunity and available health/fitness equipment, physical facilities, materials and supplies in which to apply and practice the clinical skills related to that

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intern’s field of study. The sponsoring internship site will also provide each Exercise & Sport Science Intern with the opportunity to work with that facility’s clientele as appropriate. The supervising facility will have the responsibility to provide the Intern with the appropriate equipment and opportunity to fulfill all internship basic requirements (i.e. special projects, fitness testing, program development, special populations), as well as to designate the administrative daily activities. Furthermore, the supervising facility will have the right to remove any Intern with whom they become dissatisfied and shall be relieved of any obligations to the Intern. In the event that any supervising facility’s physical facilities are deemed unsuitable for an appropriate learning experience by the Intern’s faculty supervisor, the Intern may be removed from that site and placed in an appropriate internship site. The supervising internship site also agrees to complete a midterm and final evaluation form and submit these evaluations to the faculty internship supervisor within one (1) week of the completion of the internship experience.

Each supervising internship site must provide the following items to ensure appropriate practice of clinical skills by the intern:

(1) Body composition testing equipment (i.e.: skin fold calipers, BIA device, Bod-Pod, Hydrostatic weighing, Futrex, or any other appropriate device).

(2) Cardiovascular Fitness Testing Equipment (i.e.: Lifecycle Fit-Test, YMCA Sub-Max Cardio Test, Harvard Step-Test, or any other appropriate testing protocol).

(3) Musculoskeletal Flexibility testing equipment (i.e.: Tape measure, sit & reach box, goniometer, or any other appropriate testing device).

(4) Standard Sphygmomanometer & Stethoscope.

The Exercise & Sport Science Intern will conduct a facility review during the first week of the internship at their respective internship site. A checklist of the aforementioned facility requirements will be taken. If any deficiencies in the required facilities are noted in this review, the faculty internship supervisor will personally review the facility. From this facility review, the faculty supervisor will make a written report of the deficiencies. The Internship site will have fourteen (14) days to correct the deficiencies or the intern will be placed in a new internship site.

The supervising internship facility will continue to have responsibility and liability for supervision of the facility’s daily operations, exercise equipment, physical facilities, material and supplies which it provides for the use and application of the Exercise & Sport Science Interns. Additionally, the supervising internship facility will agree to assign only duties consistent with the job description of a regularly employed health/fitness professional.

Compensation

In compliance with the Department of Labor’s requirements, Exercise & Sport Science Interns will receive nine (9) hours of academic credit for their participation in

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this internship experience. Therefore, the supervising internship facility is NOT required to financially compensate the intern for services provided. If financial compensation is to be rewarded it is the responsibility of the Intern and the supervising internship facility to determine the appropriate pay scale and schedule.

TERMThe effective date of this agreement shall be ________. This agreement shall terminate on ____________. The parties agree to discuss renewal of this agreement sixty (60) days prior to termination.

PROFESSIONAL LIABILITY INSURANCE

Each student intern shall be required to obtain a professional liability insurance policy with coverage limits of not less than $1 million per claim and $3 million aggregate, with the policy being written on an occurrence basis and subject to annual renewal. Each Intern must present written proof of such insurance to the supervising faculty member and the internship supervisor prior to the intern’s first on-site visit to the sponsoring internship site.

NONDISCRIMINATION

Each party agrees that student recruitment, admission, participation in clinical activities, and evaluation shall occur without discrimination with respect to race, color, creed, sexual orientation, age, disability, or national origin.

GOVERNING LAWS

This agreement shall be governed by the laws of the State of Maryland, and subject to the exclusive jurisdiction of Maryland State courts.

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AMENDMENTS

This agreement may be amended only in writing and signed by each of the parties to this agreement.

IN WITNESS WHEREOF, the parties, by their authorized officials, execute this agreement for Exercise & Sport Science Health/Fitness Internship.

SPONSORING INTERNSHIP SITEName of Sponsoring Site: _________________________________Address: _______________________________________________Authorized Official: (print) ________________________________Authorized Official: (signature) ____________________________Date: _________________________________________________

FROSTBURG STATE UNIVERSITYInternship Faculty Supervisor: (print) ____________________________Internship Faculty Supervisor: (signature) __________________________Date: ______________________________________________________

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