Spreadsheet: 06885ade-8745-4b7a-892a-5eec7cde0d5b
Sheet: Weeks 1-16

Internship Class Section CRN:__________
Placement School:___________________
School Code: Division ____School______ |  |  |  |  | (Codes Here)
Grade level: ________________________
Subject:____________________________
Indicate time* spent each day on the following activities:
Weeks 1-4 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Chart 1 TOTAL
Activity ↓                  Date→
Responsible  Actual Teaching
Classroom observation
Planning and/or Preparation
Pupil Evaluation
Parent Conferences (Back-to-school, Open House)
Professional Activities (workshops, conferences)
[NAME] (coaching, etc.)
*All times should be kept in multiples of hours or half(.5) hours.  A full class period will be considered as 1 hour
Indicate dates & appointed times for the following activities:
Observation by University Supervisor(s)
Conference with University Supervisor(s)
Collaboration with peers/ Other Teacher Candidates
Indicate time* spent each day on the following activities:
Weeks 5-8 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Chart 1 TOTAL
Activity ↓                  Date→
Responsible  Actual Teaching
Classroom observation
Planning and/or Preparation
Pupil Evaluation
Parent Conferences (Back-to-school, Open House)
Professional Activities (workshops, conferences)
[NAME] (coaching, etc.)
*All times should be kept in multiples of hours or half(.5) hours.  A full class period will be considered as 1 hour
Indicate dates & appointed time for the following activities:
Observation by University Supervisor(s)
Conference with University Supervisor(s)
Collaboration with peers/ Other Teacher Candidates
Indicate time* spent each day on the following activities:
Weeks 9-12 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Chart 1 TOTAL
Activity ↓                  Date→
Responsible  Actual Teaching
Classroom observation
Planning and/or Preparation
Pupil Evaluation
Parent Conferences (Back-to-school, Open House)
Professional Activities (workshops, conferences)
[NAME] (coaching, etc.)
*All times should be kept in multiples of hours or half(.5) hours.  A full class period will be considered as 1 hour
Indicate dates & appointed time for the following activities:
Observation by University Supervisor(s)
Conference with University Supervisor(s)
Collaboration with peers/ Other Teacher Candidates
Indicate time* spent each day on the following activities:
Weeks 13-16 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Chart 1 TOTAL
Activity ↓                  Date→
Responsible  Actual Teaching
Classroom observation
Planning and/or Preparation
Pupil Evaluation
Parent Conferences (Back-to-school, Open House)
Professional Activities (workshops, conferences)
[NAME] (coaching, etc.)
*All times should be kept in multiples of hours or half(.5) hours.  A full class period will be considered as 1 hour
Indicate dates & appointed time for the following activities:
Observation by University Supervisor(s)
Conference with University Supervisor(s)
Collaboration with peers/ Other Teacher Candidates
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | TOTALS
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Responsible Actual Teaching
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Other Classroom Hours
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | Total Supervised Teaching Hours
 |  |  |  |  |  |  |  |  |  |  |  |  |  |  |  | [NAME]
 |  |  |  |  |  |  |  |  |  |  |  |  | Total field Experience Hours wks1-16