Internship Supervisor Form
Record of Student Internship Hours
Student Name: _____________________________ Email Address: _______________________
Internship Start Date: _____________________ Internship End Date: _____________________
Unless otherwise agree upon, all hours must be completed within the semester.
Questions? Please contact: Juan Armijo (jarmijo@twu.edu)
Week #
Dates Worked
Total Hours Worked
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
_______________________________ __________________
Supervisor’s Signature Date
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signature
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