Internship Report Form Directions
This form must be completed monthly. Report the time you have worked on your internship duties, as arranged with your program supervisor, for each month of your internship. Briefly indicate the tasks you have performed, and if you have had any problems. If there is a month in which you have no time to report, please submit a report indicating no hours and the reason(s) why.
Student Intern Name: Enter your name
Date: Enter the date you are completing the form
Date, in body of form: Enter the date, or dates, you worked; make a separate entry for each date worked in a month
Activity / Job duties: Enter the activity of job duties you performed for each corresponding date
Location: Enter the location at which each corresponding activity or job duty took place
Start Time: Enter the time you started your internship work activity on each date
End Time: Enter the time you ended your internship work activity on each date
Total Time: Enter the total time you spent on your internship work activity on each date
Student Intern Signature: Please enter your name again in this space
Please submit completed form by the 5th of each month.
If you have any questions or concerns about your hours or your internship assignment, please contact Leah Schrock at 574-284-7132 or 800-552-7928, ext 7132 or by email at lschrock@realservicesinc.com