(REVISED) ASU AFFILIATION TEMPLATE (JAN 2011).DOCX

STUDENT PLACEMENT AGREEMENT
This Student Placement Agreement (“Agreement”) is entered into between the ARIZONA
BOARD OF REGENTS for and on behalf of ARIZONA STATE UNIVERSITY (the
“University”) and the “Facility” as of the “Effective Date.”
UNIVERSITY: FACILITY:
By: By:
Printed: Printed:
Title: Title:
Effective Date:
1. DURATION
The duration, or term, of this Agreement shall be for the designated number of years and months as agreed upon
below, not to exceed five (5) years, commencing on the Effective Date. This Agreement may be renewed by written
agreement of the parties. The parties may revise or modify this Agreement only by a written amendment signed by
both parties.
Number of Years:
2. GENERAL TERMS
2.1. The purpose of this Agreement is to establish a relationship between the University and the Facility to enable an
educational experience for students at Facility’s site that may qualify for University academic credit as
determined by University.
2.2. The University and the Facility will agree on a schedule for student participation at the Facility.
2.3. The student’s participation should complement the service and educational activities of the Facility. The student
will be under the supervision of a Facility employee.
2.4. Each student is expected to perform with high standards at all times and comply with all written policies and
regulations of the appropriate department of the Facility.
2.5. Either the Facility or the University may require withdrawal or dismissal from participation at the Facility of
any student whose performance record or conduct does not justify continuance.
2.6. Neither the University nor the Facility is obligated to provide for the student’s transportation to and from the
Facility or for health insurance for the student.
2.7. A meeting or telephone conference between representatives of the University and the Facility will occur at least
once each semester to evaluate the educational program and review this Agreement.
2.8. Statements of performance objectives for this educational experience will be the joint responsibility of
University and Facility personnel.

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2. GENERAL TERMS
2.9. Each student must adhere to the Facility’s established dress and performance standards.
3. FACILITY’S OBLIGATIONS
3.1. Facility agrees to appoint an Educational Coordinator who is responsible for the educational activities and
supervision of University students participating under this Agreement.
3.2. The Facility agrees to submit to the University an evaluation of each student’s progress. The format for the
evaluation is established by the University in consultation with the Facility.
3.3. The Facility is responsible for the acts and omissions of its employees and agents and must maintain adequate
insurance (which may include a bona fide self-insurance program) to cover any liability arising from the acts
and omissions of the Facility’s employees and agents. The Facility is not responsible for maintaining insurance
to cover liability arising from the acts and omissions of the employees and agents of the University. University
students are not deemed to be employees of Facility by virtue of this Agreement. Notwithstanding the
foregoing, pursuant to A.R.S.§23-901.06 the intern at the Facility will be covered by and subject to the
Facility’s Workers’ compensation insurance.
3.4. Each party (as "Indemnitor") agrees to defend, indemnify, and hold harmless the other party (as
"Indemnitee") from and against any and all claims, losses, liability, costs, or expenses (including reasonable
attorney's fees) (hereinafter collectively referred to as "Claims") arising out of bodily injury of any person
(including death) or property damage, but only to the extent that such Claims result in vicarious/derivative
liability to the Indemnitee and are caused by the act, omission, negligence, misconduct, or other fault of the
Indemnitor, its officers, officials, agents, employees, or volunteers.
4. UNIVERSITY’S OBLIGATIONS
4.1. The University will provide an administrative framework, including designating a University faculty or other
representatives to coordinate scheduling, provide course information and objectives, and assist in advising
students.
4.2. The University will be responsible for developing and carrying out procedures for student selection and
admission.
4.3. The University is responsible for the acts and omissions of its employees and agents and maintains insurance
coverage through the State of Arizona’s Risk Management Division self-insurance program to cover liabilities
arising from the acts and omissions of the University’s employees, students, and agents participating under this
Agreement. The University is not responsible for maintaining insurance coverage for liability arising from the
acts and omissions of the Facility’s employees and agents.
5. STATE OF ARIZONA PROVISIONS
5.1. Nondiscrimination. The parties agree to comply with all applicable state and federal laws, rules, regulations,
and executive orders governing equal employment opportunity, immigration, and nondiscrimination, including
the Americans with Disabilities Act.
5.2. Conflict of Interest. ASU’s participation in this Agreement is subject to Section 38-511 of the Arizona Revised
Statutes which provides that this Agreement may be cancelled if any person significantly involved in initiating,
negotiating, securing, drafting or creating this Agreement on behalf of University is, at any time while this
Agreement, or any extension thereof, is in effect, an employee or agent of the other party to this Agreement in
any capacity or a consultant to any other party with respect to the subject matter of this Agreement.
Revised: January, 2011

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5.3. Notice of Arbitration Statutes. Pursuant to Arizona Revised Statutes Section 12-1518, the parties
acknowledge and agree that they will be required to make use of mandatory arbitration of any legal action that
is filed in the Arizona superior court concerning a controversy arising out of this Agreement if required by
Section 12-133 of the Arizona Revised Statutes.
Revised: January, 2011

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5. STATE OF ARIZONA PROVISIONS
5.4. Failure of Legislature to Appropriate. If University’s performance under this Agreement depends upon the
appropriation of funds by the Arizona Legislature, and if the Legislature fails to appropriate the funds necessary
for performance, then University may provide written notice of this to Facility and cancel this Agreement
without further obligation of University. Appropriation is a legislative act and is beyond the control of
University.
5.5. Student Educational Records. The University and Facility recognize that student educational records are
protected by the federal Family Educational Rights and Privacy Act (FERPA) (20 U.S.C. § 1232g). FERPA
permits disclosure of student “educational records” to “school officials” that have a “legitimate educational
interest” in the information. (For definitions of quoted terms, see ASU Policy SSM 107-01: Release of Student
Information.) The federal Family Compliance Office has recognized that institutions can designate other
entities, including vendors and consultants, as “other school officials.” Designated representatives of Facility
will be designated as “other school officials” for purposes of this Agreement. No designated representative of
the Facility shall disclose student educational records it receives under this agreement to any third party, except
with the prior written consent of the student or as permitted by law. Any disclosures made by the Facility will
comply with the University’s definition of “legitimate educational interest.” Facility agrees and warrants that it
shall use student educational records solely to accomplish its obligations under this agreement and solely in a
manner and for purposes consistent with the terms and conditions of this agreement and University policies and
procedures. Facility agrees and warrants that it shall not make any disclosures of student educational records
without prior notice to and consent from the University. If any designated representative discloses or misuses
any educational record, the University and/or Facility will take appropriate action against the designated
representative that is similar to action ASU would take against one of its employees who disclosed or misused
the educational records of its students.
5.6. Representations Regarding Relationship and Use of University Marks. Except as otherwise agreed in
writing, Facility acknowledges that its relationship with University is limited to the student internship or
placement program contemplated herein. Facility shall not make any representations stating or implying that the
parties engage in broader transactions or that University is otherwise associated with Facility without first
obtaining express written permission from University. In addition, Facility shall not use any trade name,
trademark, service mark, logo, domain name, and any other distinctive brand feature owned or used by
University without prior written authorization by University.
6. MISCELLANEOUS
6.1. Neither party shall have the right to assign this Agreement without the prior written consent of the other party.
6.2. This Agreement constitutes the entire agreement and understanding of the parties with respect to its subject
matter. No prior or contemporaneous agreement or understanding will be effective. This Agreement shall be
governed by the laws of Arizona, the courts of which state shall have jurisdiction over its subject matter.
6.3. The individual signing on behalf of Facility hereby represents and warrants that s/he is duly authorized to
execute and deliver this Agreement on behalf of Facility and that this Agreement is binding upon Facility in
accordance with its terms.
6.4. This Agreement may be executed in multiple counterparts, each of which shall be deemed an original, and all of
which together shall constitute one and the same instrument.
Revised: January, 2011