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Instructor: Anita Johnston        office: JM 250
phone: 517.796.8504    email: JohnstoAnitaM@jccmi.edu

FIELD EXPERIENCE LOG...
 

Official Education Field Experience Record Sheet

 ¨ EDU 121                ¨ MTH 210/211               ¨ ENG 254               ¨ MUS 133                ¨ ART 131

Name

Student ID

 

Various courses at Jackson Community College require academic service learning field experience.  Many colleges require a minimum number of hours before student teaching (for example, Spring Arbor University requires 120 hours).  It is the students’ responsibility to keep this form accurate and updated and to return it to the instructor when requested.  Please make a copy for your own records. 

School Name and Location (address included)	Date	Grade/Subject # of students present	Total Hours	Supervisor Signature and Phone/Room Number	Focus of Visit [1]	D/S [2]

Total Hours for Page 1

  

School Name and Location (address included)	Date	Grade/Subject # of students present	Total Hours	Supervisor Signature and Phone/Room Number	Focus of Visit [3]	D/S [4]

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[1] Describe the focus of each visit such as observation, one-on-one tutoring, group facilitation, etc.

[2] Use “D” if racial/ethnic diversity was part of the experience.  Use “S” if special needs (physically challenged, emotionally impaired, learning disabilities, etc.) were part of the experience.

[3] Describe the focus of each visit such as observation, one-on-one tutoring, group facilitation, etc.

[4] Use “D” if racial/ethnic diversity was part of the experience.  Use “S” if special needs (physically challenged, emotionally impaired, learning disabilities, etc.) were part of the experience.