School Media Field Experience Record Sheet

SCHOOL OF INFORMATION SCIENCE AND POLICY, UNIVERSITY AT ALBANY, SUNY

Student Name								 ID#				

ELEMENTARY 

School Name/District

Grade Levels

High Needs?

Supervisor

Dates/Hours

Supervisor
Initials

SECONDARY 

School Name/District

Grade Levels

High Needs?

Supervisor

Dates/Hours

Supervisor
Initials

Notes: