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Azusa Pacific University MSW Program - PPSC Field Time Log
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Name:
Semester (circle one): FALL SPRING
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Scheduled Days (circle): M T W TH F S
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WeekDates:SSW HOURSCWA HOURSList Specific Activities Weekly Totals
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ex.9/26/1052documentation, observation7
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ex.9/26/1042observation, orientation6
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Totals:00Total from page 1:0
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300 hours per semester; 600 hours overall (450 SSW; 150 CWA)
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I certify that the hours claimed are accurate and true to the best of my knowledge.
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Student Signature: ___________________________________________________
 Date: _________________
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Field Instructor Signature: _____________________________________________
 Date: _________________
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Log in other hours below:Weekly Totals
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Dates:SSWCWAList Activities
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Totals:00Total from page 2:0
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Grand total from page 1 and 2:0
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300 hours per semester; 600 hours overall (450 SSW; 150 CWA)
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I certify that the hours claimed are accurate and true to the best of my knowledge.
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Student Signature: ___________________________________________________
 Date: _________________
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Field Instructor Signature: _____________________________________________
 Date: _________________
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