student affiliation agreements

The Student Affiliation Agreement is used to place students in a supervised clinical or other fieldwork experience or internship educational program. 

If the terms or conditions change on the template agreement, please notify this office as the approval of the Office of the Attorney General is required for any contractual changes.

Please check the list of Student Affiliation Agreements currently available before initiating an agreement to determine if an agreement already exists. 

Student affiliation agreement Resources

Note: Links to external sites will open in a new window.

STUDENT AFFILIATION AGREEMENTS

•     Student Affiliation Agreement template (clinical or fieldwork) - updated 11/7/11
•   Student Affiliation Agreement template (NURSING ONLY) updated 12/29/11 

•     List of Student Affiliation Agreements currently available  - updated 05/03/13

•     Student Affiliation Agreement Request Form - updated 05/03/13

SAMPLE CERTIFICATE OF RESOLUTION

•     For a corporation
•     For a corporation with a sole officer
•     For a general partnership
•     For an LLC - sole member
•     For an LLC
•    Attorney for the Institution
•    Sole Proprietorship
•    Authority to Sign on Behalf of the Firm

NONDISCRIMINATION CERTIFICATION FOR STATE CONTRACTS

•    Nondiscrimination Certification (external link)

CSU RESOLUTION AUTHORIZATION TO SIGN DOCUMENTS

•     Resolution concerning Authorization to Sign Documents for the Connecticut State University  System (external link)

 For questions regarding Student Affiliation Agreements, please contact:

Cynthia Shea-Luzik at (203)392-5490
Shawna Cleary at (203)392-6703, or
Carol Wallace at (203) 392-5453