Internship Supervision Form
(Completed by the campus/district supervisor)
| agree to serve as the Administrator Supervisor for tha \ ta l
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.
‘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.
SIGNATURE:
‘Administrative supervisor:
Title:
Date:
Phone Number:
Email address:
School/Institution:
Address: _A\\2 acwett
ip eras NRT EUS
EDUC 6330/6331 Administrative Internship
Dr. Virginia Leiker
School of Education
University of St. Thomas
3800 Montrose Boulevard
Houston, Texas 77006
47