|
Field Experience Log (Pre-Residency/Residency I) |
||||
|
Name _____________________________ School______________________ Mentor Teacher______________________ Grade______________________ Print this form to document your time and activities in your school placemetn |
||||
| Visit # |
Date |
Time In |
Time Out |
Activities |
|
1 |
|
|
|
|
| 2 |
|
|
|
|
| 3 |
|
|
|
|
| 4 |
|
|
|
|
| 5 |
|
|
|
|
| 6 |
|
|
|
|
| 7 |
|
|
|
|
| 8 |
|
|||
| 9 |
|
|||
| 10 |
|
|
|
|
| 11 |
|
|||
|
12
|
||||
| 13 |
|
|||
|
14
|
||||
|
15
|
||||
|
16
|
||||
|
Comments:
|
||||
|
The information provided above is true and accurate. __________________________________Pre-service Signature Date:__________
|
||||
|
Comments:
|
||||
|
The information provided above is true and accurate.
__________________________________Mentor Teacher Signature Date:__________
|
||||