Capstone Student Agreement

ICE's mission is to inspire clinical excellence through the creation of innovative, high-quality, and user-friendly educational resources for faculty, students, and clinicians in health professions.

Doctoral Capstone Student Collaboration Agreement
Student Name*

First NameLast Name
Student Email*
example@example.edu
Capstone Coordinator*

First NameLast Name
Capstone Coordinator Email*
example@example.edu
Faculty Mentor*

First NameLast Name
Faculty Mentor Email*
example@example.edu
Institution*
Dates of Capstone
From*

MonthDayYear
To*

MonthDayYear
Capstone Title*
Please summarize why you want to work with ICE for your Doctoral Capstone and how ICE can support you in your professional goals (150 words or less): *

0/150
Mentor-Mentee Agreement (MMA)*

Browse Files

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Independent Learning Objectives (ILP)*

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Capstone Dates

Please review and sign the agreement below.
Doctoral Capstone Student Collaboration Agreement

To ensure a smooth and successful collaboration, this Doctoral Capstone Student Collaboration Agreement ("Agreement") exists between International Clinical Educators LLC ("ICE") and {studentName} ("Student").

Capstone Title: {capstoneTitle}

Capstone Coordinator: {capstoneCoordinator}
Faculty Mentor: {mentorName}
Institution: {institution}
Dates of Capstone: {capstoneDates}
Summary: {pleaseSummarize}

Memorandum of Understanding

By engaging in this collaboration:

ICE is committed to supporting the Student's professional growth by engaging the Student in a project/experience that has potential to impact occupational therapy education and/or service delivery on a global level through the development of innovative videos and tools within the ICE Learning Center (e.g., ICE Video Library, ICE Faculty Zone, ICE DocuLearn, etc).

The Student agrees to uphold professional expectations of timeliness, respectful communication, quality work, self-directed learning, positive attitude, and growth mindset. The Student is responsible for tracking hours, communicating with faculty mentor, monitoring progress, and communicating when help is needed.

Nondisclosure Agreement

During discussions between the Student and ICE affiliates (including employees, consultants, and volunteers) relating to and for the purpose of collaboration, ICE may disclose information it considers proprietary and confidential ('"Confidential Information").:
1. Confidential Information from ICE may be used by the Student only in connection with the completion of the Doctoral Capstone Project and Experience.
2. The Student shall protect the confidentiality ICE's Confidential Information in the same manner he/she protects the confidentiality of his/her own proprietary and confidential information of like kind.
3. Confidential Information shall always remain the property of ICE. No license under any trade secrets, copyrights, or other rights is granted by this Agreement or any disclosure of Confidential Information hereunder.
4. Confidential Information, handouts, videos, photos, or other proprietary content from ICE may not be copied, reproduced, or distributed by the Student without prior written consent from ICE.
Agreement of Ownership

Materials (e.g., videos, handouts, images, products, writings, recommendations, etc) produced by the Student during the development and delivery of the capstone belong to ICE. The Student does not own the materials created from participation and releases ICE from any expectation of privacy or liability associated with participation. This Agreement is given without expectation of compensation or other remuneration, now or in the future.

Noncompete Agreement

The Student agrees not to directly or indirectly compete with the business of ICE and its successors during the period of the capstone development and delivery and for five years following capstone completion. The term "not compete" as used herein shall mean that the Student shall not own, manage, consult, or be employed in a business substantially similar to, or competitive with, the business of ICE. The Student acknowledges that ICE shall or may in reliance of this agreement provide the Student with access to trade secrets, customers, and other confidential data and good will. The Student agrees to retain said information as confidential and not use said information on his or her own behalf or disclose same to any third party.

By signing below, I acknowledge that I have read and agree to all information included in this Agreement, including the Memorandum of Understanding, Nondisclosure Agreement, Agreement of Ownership, and Noncompete Agreement.

Acknowledged and Agreed as of {date}.
{studentName}
Signature*

Clear
Date*

MonthDayYear
Consent to be Recorded (OPTIONAL)

I understand that my participation with ICE does not require being personally recorded and that this is an optional section of the agreement.

I hereby give my consent to International Clinical Educators LLC ("ICE"), its affiliates and agents, to use my image and likeness and/or any verbal statements from me in its internal and external publications, media activities, and for any other purposes. I understand that I do not own the materials created from my participation and release ICE from any expectation of privacy or liability associated with my participation. This agreement is given without expectation of compensation or other remuneration, now or in the future. This consent is given in perpetuity and does not require further approval by me.

This consent includes, but is not limited to:

(a) Permission to interview, film, photograph, record, or otherwise make a video reproduction of me
{permission}

Acknowledged and Agreed as of {date130}.
Consent to be Recorded

I, {studentName}, hereby give my consent to International Clinical Educators LLC ("ICE"), its affiliates and agents, to use my image and likeness and/or any verbal statements from me in its internal and external publications, media activities, and for any other purposes. I understand that I do not own the materials created from my participation and release ICE from any expectation of privacy or liability associated with my participation. This agreement is given without expectation of compensation or other remuneration, now or in the future. This consent is given in perpetuity and does not require further approval by me.

This consent includes, but is not limited to:

(a) Permission to interview, film, photograph, record, or otherwise make a video reproduction of me
{permission}

Acknowledged and Agreed as of {date130}.
Name Permission

Permission to use my full namePermission to use my first name onlyRemain anonymous
Permission
Signature

Clear
Date

MonthDayYear
Should be Empty:

Doctoral Capstone Student Collaboration Agreement