Form Ds-7002 - Training/internship Placement Plan Page 3
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4SECTION 4: TRAINING/INTERNSHIP PLACEMENT PLAN
Each Training/Internship Placement Plan should cover a definite period of time and should consist of definite phases of training or tasks performed with
a specific objective for each phase. The plan must also contain information on how the trainees/interns will accomplish those objectives (e.g. classes,
individual instruction, shadowing). Each phase must build upon the previous phase to show a progression in the training/internship. A separate copy of
pages 3 and 4 must be completed for each phase if applicable (e.g.; if the trainee/intern is rotating through different departments).
Surname/Primary, Given Name(s) (must match passport name)
The Exchange Visitor is:
Program Sponsor
Program Number
Main Program Supervisor/POC at Host Organization
Supervisor Contact Information
Phone
Fax
Title
Email
PHASE INFORMATION
Phase Site Name
Training/Internship Field
Phase Site Address
Phase Name
Start Date (mm-dd-yyyy) of Phase
End Date (mm-dd-yyyy) of Phase
Phase
of
Primary Phase Supervisor
Supervisor Title
E-mail
Phone Number
Description of Trainee/Intern's role for this program or phase
Specific goals and objectives for this program or phase
Please list the names and titles of those who will provide continuous (for example, daily) supervision of the Trainee/Intern, including the primary
supervisor. What are these persons' qualifications to teach the planned learning?
What plans are in place for the Trainee/Intern to participate in cultural activities while in the United States?
What specific knowledge, skills, or techniques will be learned?
How specifically will these knowledge, skills, or techniques be taught? Include specific tasks and activities (Interns) and/ or methodology of training
and chronology/syllabus (Trainees).
DS-7002
Page 3 of 4
03-2015
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