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CSU Chico Intern Program

Intern Support and Supervision Log
Directions for Completing this form
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Intern Name:Semester 1General Support
(72 hrs)		EL Support
(23 hrs)		EFH
Spec. Ed.
(200 hrs over the course of the program; prerequisites included)
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Local Support Teacher's Name: Semester 2General Support
(72 hrs)		EL Support
(23 hrs)		EFH
Spec. Ed.
(200 hrs over the course of the program; prerequisites included)
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University Supervisor's Name:Semester 3General Support
(72 hrs)		EL Support
(23 hrs)		EFH
Spec. Ed.
(200 hrs over the course of the program; prerequisites included)
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Date Internship Began:Semester 4General Support
(72 hrs)		EL Support
(23 hrs)
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Credential:Year in Program: Total0.00.00.0
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Interns are required to document a minimum of 5 hours of general support for every 5 instructional days and must have a minimum of 144 documented general support through the last day of contracted instruction with students. Interns who do not hold an EL Authorization must document a total of 45 hours of EL specific support, meeting the needs of English Learners. Interns are required to have a total of 189 support hours by the end of the contracted work year (144 general + 45 EL = 189). In addition, Education Specialist interns are required to have 200 Early Fieldwork hours prior to their last semester teaching, at least 50 of those hours must be in a general education setting. If you have any issues with your support log, email kschreder@csuchico.eduRemaining Hours288.0180.0200.0
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Hours Required: 72 GS/23 EL per semester and 200 over the course of the program
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DateDescription of SupportCategorySupport Provided By Indicate number of hours receivedTotal HoursEarly Fieldwork
(General Education)		Total HoursEarly Fieldwork
(Special Education)		Total HoursDownload, sign and date to confirn hours each semester:
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General Support
(144 hrs)		EL Support (45 hrs)Co-TeachingCo-PlanningGuided ObservationsCo-TeachingCo-PlanningGuided Observations
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12/2/2023Other:0.00.00.0
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​0.00.00.0Student SignatureDate
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Local Support Teacher Signature
Date
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