INTERNSHIP WEEKLY REPORT FORM Must be typed! Proofread before submitting!

________________________________________________________________________ NAME______________________________________ CHFD REPORT #_____ DATE __________ TO __________ Georgia Southern University P.O. Box 8021 Statesboro, GA 30460 WEEKLY TIME RECORD Total Hours Worked During This Reporting Period ______ ________________________________________________________________________ Summarize and evaluate your internship experiences during the previous week by responding to the following: (Note: Responses must be typed) 1. Briefly describe the tasks you accomplished during the week. Also, discuss which objectives were met for the week.

2. What new experiences did you encounter in the workplace during this reporting period? What important knowledge or skills did you gain during this period?

3. What skills or knowledge that you learned in CHFD classes did you use during this period? (Discuss the classes by name).

with 10 as the most favorable situation. address. Rate the week’s learning experience on a scale of 1 to 10. . What tasks were you asked to perform that you were not adequately prepared by our program or the university to perform? 5.4. or e-mail address change. Any suggestions for improvement at your internship site? Be specific and remember that this information will be kept confidential. 6. Additional comments: SITE NAME ______________________________ SITE ADDRESS ___________________________ SITE SUPERVISOR’S NAME__________________________ SUPERVISOR’S PHONE # ___________________ _______________________________________________ Intern’s Signature (required only if report is sent by regular mail) Remember to contact your CHFD Internship Supervisor immediately if your phone number. 1 2 3 4 5 6 7 8 9 10 7.

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