Only Field Education hours should be listed. Hours enumerated should not include additional work contracted between student and setting beyond tasks specified in this agreement.

For Program Year Beginning: _____________________ Ending: _____________________

Weekly Schedule:
Approximate; need will cause some variation, but the basic plan should be specified here.

EVENT                                                                                       HOURS
1. Tasks

2. Supervision: Individual
                      IC & ITP

3. Staff Meeting

4. Preparation

5. Travel

6. Other Responsibilities
    TOTAL HOURS PER WEEK

TASK                                                              DAY OF WEEK                                                 TIME
 
 
 
 
 
 
 

Expense Arrangements:
If applicable; i.e travel reimbursement, remuneration, etc.
 
 

Early Termination: This agreement should not be terminated by either party without a joint conference between the staff of the Office of Professional Education, the student, and the supervisor. The details of termination are to be worked out at that conference.

Vacation Periods:
See BUSTH calendar.

1. From ____________________ to ____________________
                 (day and date)                     (day and date)

2. From ____________________ to ____________________
                 (day and date)                     (day and date)

3. From ____________________ to ____________________
                 (day and date)                     (day and date)