Time

Started

Ex:8:30am

Time Completed Ex: 9:30am

rfu)
$,t(ta-^t

u.f*ti'r,lt_,pu,e1 6Lt1'r,r['Pu'r

.Dq:-id
latu de+-v'J {r11 gu1 i}''cj' "ltr'L"-* E*.i'.t 1."trtr't tt\e'di-l t\--u\L-r,l'.J'\ tt\ edi-l lr \\.J -'r\ \U IrtU'e\'i\'ls'\ 'lAttc-k: {\i:'q[q - - "'Eu\**:d

[{({itci'.f r Pt} \ Cr(xt L [it''{*. ir\ 1-trtit=ltFi elt-\\tri t\G-i--r-( *uu- Ctd*\-} CtA\-l \tr: tr. {. *ur QG-r-ur*

{ciirl\U v' cbxi uor,si - [ktt-,,,r*" -\vi; tru{ i c cLiir"t'u' Yl tiru"jri*'it\ c'll+ rr \clr.e4 gttruJ'
I

'-,u'(i\ftfi\ q '+r-\ f1i'lu\ I r - i - - ^.t

r\'";;e i.Q
'.J v

{,Li'

L.

cri lib\1ut

-L{,1*

rL*r

d.{Y.-i..,tu+:ruqY{u

rq -/ hc
*__

(,crLvL
1,i

r.

'c{,f:r

Stadc{.l I LUr s(tt Li-\r. r \r-1 f,t"A$ *r.& ,*UJq ;i, tnkt- \IXLYL --,r\.ig,Rr,i, I vr,_t * t i r i[', t;l'ln lu'+" ht,Ytl - tn , t, \,i -1,'r\;;rl.-I*, nd' * ,1t 'f i.,l{l ;r,,li,L - \ "'ttn.'i!t,,' Nt;3*-tA\
-->

i,f,?i.i,r,r,,

ti:ruw*'

Signature of Supervising Teac

The Student will return this form to School of Education Offtce, MRC 401. STUDENTS: You will not be given credit unless the teacher signs above!

VITERBO UNIVERSITY
SCHOOL OF EDUCATION FIELD EXPERIENCE

flt1h"lcq.''i
Student lD#

has been assigned to your class for observation

and/orparticipatinsrrom:
Days

lC q l;;C f '. li Monih/Dater./ear

to i!

i Month/Date/Year

lC

(i

/]c'l i

/\\-k
Q

rir"ffip-.rl'\

University Cour."

The student will complete the following log, but may we ask you to verify his/her experience at completion? FIELD EXPERIENCE LOG Activities Daily Time Date Time Total Completed Started Er 9:30am Ex: 8:30am

tl#laul

l.

U'

.'\-.rlth'

- (tC(L r\\L i\.1rC, r-y*1C1,. -'..'1'\ 5\ .\^,{,-'i. , l. aoitCil),;"'* i 'ia},Jt;iL.','.'

)l
'i

-tl,-g..."S.*RiLi,l-trP1

tri. ui'] ':f'u{' rJt' \r i- -,fi. ii - (-r-L'.r:Li'(.1 t.'.-llqR.,' Lci )-t [i-'11 iLi '' '""'\ -lr-i-rLr 1 ;ai'"'.'i,3,rr. t-,r\ u.; ij*,L rt;J;":1, "{ 5 l'-rlk,,r,rit t1. ut-u, I t -Ll 'i\ .i. 1., -i', \ , y'.i'r,t !1{/,.:'$:i.nr! ti t i \.ti'''l' {- r rr-|-il .: p .
,.t-

.t*J gt"uu\c--t=t,,\

.-t \u-f\)rr L i'ltt uJ qoir\\LiL''Y- \:)tr(' -c "- "JpqK.t -y*q<t " JrL'.**L I -Cll..l*'l-. Jt
: ",,

..1

-fI

tirr,"-. i ti.,wc t', ir,,.,i -Lt. *{rt' Grlr.,' ' ,- 6..',.i't \< i) rt-* tt , d ;; itf i'i-u{:i*t " - .Err tiltut'ru i r \,r \h t" , t-'. -,'t\ L \ " g,.ri\ \,,.'{[(iv,:" ] {c, " qi\t-ti*!'t il r\trtr(rLJ -t--"*'tiJ r,r. -l.r '(ic' ,l r \tti-; r uulir'I rx
\(

i - t'*-.. . .lT i,"l; li r.) - iti.."' ,, ", 1\\c'*5'{ r-vrl(tf :'('rt i:*-tr$ rr tiiit..,',r,)--Lc |u;&; .J-rr ci')'f t''

*"'ll;

E"g.r\Irn,'*ttf *L.,:,;: !'ik "':

LL
i.i,

l-illtt t(]
rj1i-1 +' i--l
t
I

rt/

,l ' J ,-,-l ( \

LJ.

\-

I'r

iF

n{k'r

l: i5
me

:f. .,tr*i-o,t",i 1,J !.tuur (tfttu, . r--[,,ii'J '15'f r'u'a ' ;"-! l[f l, i-0.1.{,r1,-r d-r,';'yrr 3curnJ- lfrll- !ffi*ft- {:id,6,l,icl svtt+\o,L k *.[i[- qr't-".irz, u 6-J.ttfJI - LL,,',if ,fo* l{t:r, l.i'.'-ri fl,{:t'/,t*i r"} ir,..- L{ :,.1r*''v-t't'. .";lu'io.* , ii {tt}.:) ft; L{!1,1l*:;{"Y:Y. f;r* {erb{g, "fi- ypu&rtq ,t{"|rtth

J tlsit

LC

-.

Students: Falsification of field experience records

a'i'l, "-. 'u.t{ tw", ' '; t'i' i|"5^*!*/k,f,.j#,'tr ph6\4rt.'' ol aorl^*r' " {'iUf,X ttj [r.ttt'.tl--[,,lrn t {ial;x {t j iuritcl{ t ii'r\,U** 1,rtry .r .ti\ \ \-1,/ "-'r-i,l\-'..ri \ I , r.\\1\ {. ,l'ii tu i, ,' ii rt tn it u,{,ft,tC i' [Paf',, "t 't{'LL

, utltt . h

vt*dl*i/
,ttil;*,

'rl,

,r,nn

1,r.,,

I irifi fik,,.rl r{t ic*l f't,"L

Li
t)

dL{

L'{

".i,{.

',i;:

Time
Started

Ex:8:30am

Time Completed Ex:9:30am

B: lsan

lJ $\L\!_ \,00r-JkJ/.tq
nnsw
{o-[Maa,

.qrL,

#frf,#+"seffi

x#*;hMffi
'vut fYlafu "0]l^r- YI\Qx

qeoKi e[ /u9orn Qzn-i'rsafr/'5,'

b\4]

n rnil\l,hA oiu{l tDcl

\{4} wXS*,Sfl\s

ffie_ryffiW
-SPmina $/ha-rn Ln wY

ffi

Kls
@@
J Total Irours ^ ,\C.-Jl

-futd.}fu, @ sep- \rn..g"&\' tes' strd+4* hau -otil-*-'&ri- a-'fur*: *16$cit* ftev te: ^A0
\D \odkNrco{\ o^r aflg.,eltru' ,n co o,A toeo&U Voee4B - o'v o'vatO.,0ft-' i-t/L q.A-Ad

H 6(qrd u(t -

"60

rril^# r*U+ t,tt. \rr@k a t-o.,1s \o hs \.astretrfl .:"/Lo cr)61!(QP6'

fuH[ffiffiWl^M,'ffiS*a
,L

L^hr:
hw,r4

Signature of Supervising Teacher: verification exlerience)

School:

The Student will retum this form to School of Education Offrce, MRC 401. STTIDENTS: You will not be given credit unless the teacher signs above!

VETffiRffiffi UruEVffiR.SETY
SCHOOL OF EDUCATION FIELD EXPERIENCE Date

&3ffiruQt
Student lD#

has been asiigned to your class for observation

and/orpariicipatinsrrom: ," I?IHIL,I,HJ3

Days

Time

University Course The student will complete the following log, but may we ask you to verify his/her experience at completion? FIELD EXPERIENCE LOG Time
Completed Ex: 9:30am

Qlaafil

6", 3oc.-,nn

,\i.u cL

\E{,

ffi$$

tz il.aau'la
Students: Falsification of field experience records may lead to dismissal frorn the program.

Date

Time
Started

Ex: 8:30am

Time Completed Ex: 9:30am

Daily
Total

Activities

Lb rtw s{riaj.xvt I tll-td.g :-\LB-t.t-] -.{'{Yxr*irW

l.qXfLrti'SILL t9rr\ L\*\!t<(SCIaJWq{)

! $:donJ,c eK$u-td

.A-$Vrcn*l USd cict-c}LL/1ct - +p" 3cr*tv6<-

l-+,.un &r cuc-lr :,\i t{- -ur^d lqeuu \-tvou<0r <zqclt s[d4-cu\d hi\^NS tt,*.Y Yusd t.: i'rruludrLe-1"\ -cx-0-tcrc{ h., $t(l,A'lilY*n,c u,v nrored nrorefl -.r -\-"U,r l- N$.}t. 5\<*t et t'Lc, +rt - 'Fftrk^) *,il'u,.gU"+O - tq'91,:i3yi' hri-frr.. #ft,$'G-'I-vio"Pii4 f\1 ;'-Ft'n n,t": VJr O*-tL t t1^ t.,

"ffi"Y.ii#) f

n*:,P1ffi),ffiml,fri rq*3
e-rr\
cr..

},$Li

z'l

, rtr "'4r'l'tct'; I

') fuN tt

"**rrg
---,]
Total

Z,Z\

-'h<rd

to gtell

*D

d,.{,-{A-'Ck -<.Y?Ol-.rLlr

Ilours 3,

?5
;i&iU, ,/
tl
1

H#Plh#,Y,,mo,ftr#
(si

Signature of Supervising Teachgi

.flft $ ,'.

iwt u*

cat on

The Student will return this form to School of Education Office, N/A-C 401. STLIDEI.ITS: You wiil not be given credit u:iless the teacher sim,s above!

VITERBO UNIVERSITY
SCHOOL OF EDUCATION FIELD EXPERIENCE Student ID#

has been assigned to your ctass for observation

o.y, ,.M'' I
University Course The student will complete the following log, but may we ask you to verify his/her experience at completion? FIELD EXPERIENCE LOG Activities Daily Time Time Date Total Completed Started Ex: 9:30am Ex: 8:30am

iljlrii1

'ir - *,

Ar^,frt

Ci,:2aiee,frl

-:j. {\Lt\r'\!rl {.t|.-{C9-t

:

'l-., 11''"it t, {L^{,+\

(\
j

- ilft-tk t'{S'i. r-''*i"\ {:)! c: t "..ll-t'-l ;-':-(r-l'i-. i. :j! i-i- i)1 i I lucd rJ$ r 4lt '1 \t u "-sr {'11 't e -'{ '' - , it.]'.,i t 2r' , ! l'"
"/---------------,

::;:Jl),

11",'-,*

::t)

-t:

xl'.t l-ftT
.V,

rt
! i-L

{'l L/i r
_]

l'i-C*t;rr* i'it
;c'r.1-1 IU.r
-f
: l-Lr

-t,-, \!'r
,l

rutffr ttk ffi'Iil+e

': tr1it{, t'rutlq,,I

i)
t-'. qu-&L1 t ii

tudi uta

l{ctr-(

stu dents: Fatsirication of fi eld experience records

r.frL$,t *J'S"l;;*1[: --\-5.rr'frilf it*t i\ \t\\=t \dr,td

't

. t"

,-\t\ *'k \, u (*.,

a$.

"ii\\ Lri i"N-,tt

,b

-r :1 {r, r i" \l ' tr'trr,\,)

1t'r:' J

Date

Time
Started

Ex: 8:30am

Time Completed Ex: 9:3Oam

Daily Total

Activities

\\\&-,'';.-{\\\tl. r-. t {d'i-d qCf\} f 1,1.(.\tt^-'l . r -,"3*-'l"t,'*- rg,.Itft:r'iuvvr [tl-v' \,rtcr'

1,r.r.

di*>r.,b{ct u,i:\tt\* ,: r-i\yJ- [\'<$ tr, r

,L.

.":.I

Nruh\r'ut

lJl l[p,vr t:75

raloa $\ l5a,rv)

frft1t

hHilffiIl!

a0rcu-lw-t \"t*.],..1(

.^' .

8", BOn vn Total Hours

"'L5
r
''i

3, DO
"
(Si

bc0k5 iU,-urr.
'
-

c$",t\d

NtL\ 'Vr.!.,,fo\
''i

.,

L^$\ptr h]

- u"

Signature of Supervising Teach.., ,

!
School:

''f ,'' n/ -' -* gnaffi r;J indil atp s ve{i#cati on

.t-"

of hours and et'perience)

The Student will return this form to School of Education Offtce, MRC 401. STUDENTS: You will not be given credit unless the teacher signs above!

VETffiRffi# UruEVffiRSEFY
SCHOOL OF EDUCATION FIELD EXPERIENCE
Date

3 /calJc(
Mohth/Datdllear

Student ID#

+1
LasUFirst/Middle lniiial

has been assigned to your class for observation

and/or

pa

rticipating from

o"u,

,.ft{'EFIELD EXPERIENCE LOG

University Course
The studentwillcomplete the following log, but maywe ask you to verify his/herexperience at

completion?

'foelt 3

Uhoft.[-i zt tt "\h "u'h*r I,-H-o',.,et{-1^-s- t-p<hr*t kx r'tn v y.-{-uocqlnf f SIG;4"-tU.Yuttqx "tfr l:."-gftr:diYilrqx ,.-{-tr"l6e"F
v

/LJ'6']

)*i..,u:eL tn-q6.kxtt\ \ *r rt .i ;i';{rhe.r'i.lt'q r4m';n.-lt sitJd\.k uc.rL h\to /;1:i1* *u i[*t uo ''Oru6eir"1
rrc,

uv-sw&uyt'1,Y),9Wff*,&; . L,t hlt)C-f,4 f i,..r' t'Dla ht -t Xry,J0 f ,,. a h.4 - r *.\

Jryusr/dFav\

t!,,dry'{tf

- tuil;rrc\ (L AiII\n u.$.\4l de' cgfr.p(-l-J rvrtdl t,ilt x,$'e' [t(-d ur ry.c (W-oa,^.-,:'ul^r N- (df - Q t.(e'.,"u-u1 c3[u'-s ) --4toto-^rr: (a'b L.,Q \'o .-".,6;i',\occtrc O-rk( w'{61!"c,i u}r uu hq-+ t-u,--} .
v
t

tii-tJntilidgrw, c\,l'vl -'ulNqe Shettu

- [\J '- Pitr.aw*r- ft\o*t'u dlt*["N",'un,,sNXuA {\\de, - cc$

"\j o;.t,!*'/.' [rr[c$ud;;iil.\ kl"

,

.- ffiu,Jlrq-te.ttlt*,"

u(\\\ (\1
U

O.L;r.,,fNj

.- eN-L 1-hy-Lyu\t -- Olrtur ii;$!\q"

".tAdq.n

rShLV\"q)

t$tqil.1*r *fft\\o-hl

V4tr:ter wtVzt'fitr.

Sb'-e

t
h-u.{

b [,t_{_*t\$-+

*ru1ry15ryxr+-'tc soalt.h",}
Students:FaIsificationoffieIdexperiencerecordsmayIe}dtodismissaIfrorntheprogram'd.s"V<

d.,g^r r,. VJfn4p,v

[a-r .yvU\eS

,Lc/\_vrg

\l:e*-.-dn

Time
Started

Ex: 8:30am

Time Completed Ex:9:3Oam

Activities

\i\ss$--r

Uilru c{op'rr\ (*tp,,r"-.b) \ \ \n - :\,.. d[N\ \q-ql\Lci,: 1\t .\,[$\. \qr rche-i,'ver'WDr-!r't[u cnr *t +)+" Uuo.rc.t Ah,\\ bo-\

\:u.S5>to$+o\to
-{Y\L\--( V\\S\\L\ b1\\\ ua\ r\ '*!ru-\' wsilt\

V:a vJL madrr l\\

+r.-irq;psi,'-u\r Gcs!."u+^. ql.t

l:15{urn

t1:?N::s')'\Yt

.tffi{Ln*q ar.l !" Lft\ :U { q\Nqt, t n }hu+ \qld'r "-r<ad Ys\' dili*aflqflffiwL.y**!, t":,b"- bur \,hgr,,L pc^iS./Y\L'ux. 1" P*eP ** *\:
-

SS*\-wlru1-

{"oeorn
Total

ffi;Ws\W'"i:F doiru,
V ec'11 GJr<. t>. -,*r.tv', 1,/.* l\ D

llours

l, ?-t;

Signature of Supervising T
ence)

The Student will retur:r this form to School of Education Offi.ce, I,m-C 40i. STLIDENTS: You wili not be given credit unless the teacher sigrs above!