Practicum Participation Agreement
Please print and fill-out.

This form is needed only for practica taken outside of Hopkins, and protect both the fellow and the organization at which the practicum is held.

THIS AGREEMENT is made this __ day of _______________, 200__ by and between Johns Hopkins University (AJHU@), and ___________________________________ (AFellow@) and ____________________________ (ACompany@).

WHEREAS, JHU, Fellow and Company desire to enter into a relationship to engage in a Health Science Informatics Practicum as described on the Health Science Informatics Practicum Responsibilities document which is attached hereto as Exhibit A; and

WHEREAS, the Practicum will begin on or about the __ day of __________________, and terminate on or about the ___ day of ___________________, ______; and

WHEREAS to further the goals and obtain the benefits of the Health Science Informatics Practicum, the Parties have entered into this agreement.

1. Fellow agrees to participate in a Practicum sponsored by Company to accomplish the objectives agreed between Fellow and _____________________ (Preceptor). Fellow understands that there will be no salary or other remuneration paid for any work of Fellow in connection with the Practicum. Fellow desires the opportunity to work with the Company and Preceptor in furtherance of Fellow=s education and training. Fellow understands that Fellow will not be entitled to any company benefits of any kind, nor will Fellow be covered by Worker=s Compensation or other insurance. Fellow agrees and understands that neither JHU nor Company will be liable to Fellow for any injury or loss in connection with the Practicum. This agreement by Fellow represents valuable consideration to JHU and Company for permitting Fellow to participate in the Practicum.

2. Proprietary Information. During the course of the Practicum, Fellow may receive or have access to Proprietary Information of Company. Fellow agrees to maintain such Proprietary Information confidential and not to disclose same to third parties not entitled to receive such Proprietary Information. For the purpose of this section, Proprietary Information shall not include information which is or becomes a part of the public domain through no act or omission of Fellow, was in Fellow=s lawful possession prior to the disclosure and had not been obtained by Fellow either directly or indirectly from Company, that has been lawfully disclosed to Fellow by a third party without restriction on disclosure, or is independently developed by Fellow.

3. Practicum Report. As described in the Practicum detail, Fellow will produce a report concerning the Practicum, and submit same to Company and JHU, both of whom may use such report for such purposes as are reasonably necessary to the mission of JHU and Company. Fellow shall not include Company Proprietary Information in the Practicum report.

4. Intellectual Property.

4.1. Patentable Inventions. Any patenable inventions which may be developed by Fellow using Company Proprietary Information will be considered the invention of Company and Fellow will assign same to Company. Other intellectual property developed solely by Fellow shall be the property of Fellow, subject to the Johns Hopkins University Intellectual Property Policy. Patentable inventions jointly developed by Fellow and employees of Company shall be jointly owned and Fellow's interest shall be governed by the Johns Hopkins University Policy on Intellectual Property.

4.2. Copyrightable Materials. Ownership and copyright to any reports or other copyrightable materials prepared by Fellow during the Practicum shall be governed by the United States Copyright Law. However, Fellow, the Johns Hopkins University and Company, to the extent that each would not have a joint or individual ownership and copyright interest, shall have a perpetual royalty free license to use any reports and other copyrightable materials prepared by Fellow during the course of the Practicum for any and all purposes reasonably necessary to the education of Fellow, and to the mission of JHU and Company. Such license shall not affect a party's duties concerning protection of Proprietary Information.

The Parties hereto intending to be legally bound have affixed their seals and signatures hereto on the dates indicated.