Waverly Shell Rock Agricultural Education Department

SAE Visit Record

1. Student Name: _________________________

2. Date of Visit: _________________________

3. Parents’/Guardians’ in Attendance: _________________________

4. Site of SAE Visit: ❑ Home ❑ School ❑ Lab ❑ Work Site ❑ Other

5. SAE Description: ____________________________________________________________

6. Program Area: _________________________

7. Current Progress with Records:

8. Observed Student Interest in Classroom/FFA/SAE:

9. Parents’/Guardians’ Wishes for the Student:

10. Supervised Experience Opportunities for Student:

11. Other Notes:

Teacher Signature: _______________________ Student Signature:_______________________