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Internship Supervision Form (completed by the eampusidistit supervisor) Lagree to serve as the Administrator Supervisor for WE eite Love [understand that my responsibilities include the following: 1. Supervising the intern during the field experiences noted in the syllabus, such as but not limited to the following: facilitating access to campus or district personnel, allowing the intern to shadow me or a fellow administrator, validating the intern’s activity log. 2, Assisting and guiding the intern as problems may arise in completing the specified field experiences. 3, Evaluating the intern at the end of the internship. strative supervisor_ NQtA\ie, Beuitt [ike Title: Sear Manager Special Educects on Date: 1/29]2, Phone Number: “119-434-4790 Email address: _Aprut@nossimaisd org School/Institution: Special Edu Address: 0. zip: ods EDUC 6330 Administrative Internship Dr. Virginia Leiker School of Education University of St. Thomas 3800 Montrose Boulevard Houston, Texas 77006

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