Clear Springs High Schoo
ISM- Mentorship Activity Log
Student's Name: Tees Hugh S retod 1 rota act Houser wets Ze oe
weeror_4_» 104 18 Total Hours with Mento for weeks 3 _eSGrs_O_ min
Day/Time Detail of Mentorship Activities ‘Activity | Mentor Mentor Signature
Hours | Hours: (REQUIRED)
MONDAY
ate: 4/10/18
Time
TUESDAY
Discussed proiect 7
ate: $
eee (CLS eit te enn a 4
Tm LEM-UEM | -Shadaused, bulk pyre ausistont f Salim
‘WEDNESDAY
ate: (2/19
Time:
THURSDAY
= Shadpued physician assiston +
one (3/15 | ana sem P
Time DPM-ZPm | ~trole phate wth Solin
FRIDAY
ate: 4/14 / | $
Time:
SATURDAY
ue: 4/15/13 |
Time:
| SUNDAY,
one (16/13
Time:
nt var cound oreo ane io 0 in
Your mentor MUST sgn fr actual mentorship days/hours see sample page); Activity Logs missing the required mentor signature(s) will
not be accepted for credit towards mentorship hours.
‘You are expacted to document and total BOTH “mantorship” [at least 3 hours) and “activity” (2 hours)
“Mentorship acthity Logs ae due EVERY Monday. -2Spoints each day late, ZERO after 2 days)
Students MUST show an average of 3 “mentorship” hours per week for course credit!
You are expected to turn in a mentorship log each week, even ifyouare unable to meet wlth your mentor. #fthiss the cas, please
|ocument when/how you plan to make up the hours. You should sill document at least 2 “activity” hours,Student's Name:
Week of:
Clear Springs High School
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ISM- Mentorship Activity Log
ahes ee
Total Hours with Mentor for We:
Total Activity Hours for week; 2 “Fours Omi
| Day/Time
Detail of Mentorship Activities
‘Aatvity
Hours
‘Mentor
Hours
| Swientor Signature
(REQUIRED)
Times
MONDAY
ace: 4/17/38
TUESDAY
oa 4/13/19 > shadowed Salim
rine: — 3: 30pA
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ies
| hr
30min
Time:
‘WEDNESDAY
dare: 4/j4/ 18
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THURSDAY
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Time
vat: fz [18
Ve
Time
‘SATURDAY
oae: 4/22/19
IMPORTANT:
‘Always round your time to the nearest halt-hour (30 mins.)
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‘Your mentor MUST sign for actual mentorship days/hours (see sample page); Activity Logs missing the required mentor signature) will
not be accepted for credit towards mentorship hours,
‘You are expected ro document and total BOTH "mentorship" (atleast 3 hous) and “activity (2 hours)
Mentorship Activity Logs ara due EVERY Monday. (-25points each day late, ZERO after 2 days)
Slucents MUST show an average of 3 "mentorship" hours per week far course credit!
"You are expected to turn ina mentarship lag each we
{document when/how you plan to make up the hours. You should stil document st least? "activity" hous.
leven ifyou are unable to meet with your mentor. Hf thisis the case, pleaseClear Springs High School
ISM- Mentorship Activity Log
srudents tame period: I tort et Hous tor west: 2 pours in
wieekor_ 424 Total Hours with Mentor fer Week: _3 tours 30 M4
vate: 4/25/18 [Vaccines
Day/Time Detail of Mentorship Activities ‘ality | Mentor | Mentor Signature
Hours | Hours (REQUIRED)
MONDAY 7
pate: 4/24/16
Tne
TUESDAY
Discussed He adinnistrahon of
Tine: 9 = 32 ppun) Shadowed lips an esas, Sal 30
Ihr
mn
WEDNESDAY
Date: 426/13
Time
(he
‘THURSDAY
Disceised fepes oF vaceurer giren
pare: 4/27/18 |v Kids, faked about pret dhe /™
Time A= FEM _| Shadowed physician 43515 kant |
FRIDAY
one 5p
Time:
‘SATURDAY
ate: Vogl
Time:
[pate 4/30/18
Time:
IMPORTANT:
TATTWORT)
+ Your mentor MUST sign for actual mentorship days/hours (see sample pagel; Activity Logs missing the required mentor signature(s) will
not be accepted for credit towards mentorship hours.
‘You are expected ro turn ina mentorship log each wes
‘You are expected to document and total BOTH “mentorship” atleast 3 hours) and “actvity" (2 hours)
Mentorship Activity Logs are due EVERY Monday. (-25points each day late, ZERO after 2 days)
‘Students MUST show an average of 8 “mentorship” hours per week for course credit!
ven if you ate unable to mect with your mentor. fthisis the case, please
‘document when/how you plan to make up the hours. You should stil document atleast 2“actity" hours