Student Teaching Cumulative Log
Important Notice: This form must be properly completed and submitted to the
teacher licensure office immediately following completion of the student teaching
assignment. Please calculate the minutes to the closest quarter of an hour for easier
addition (i.e., for 2 hrs. 45 min. = 2.75). The columns must be totaled on the right of
the sheet. Failure to submit this form will result in (1) failing grade for the student
teaching experience and (2) lack of eligibility for a teaching license.
Student Teacher:
Semester/Yr.
Starting date of 1st
Placement:
Ending date of 1st
Placement:
School:
Ending date of 2nd
Placement:
School:
Grade/Subject:
Teacher:
1
4
2
Starting date of 2nd
Placement:
3
5
Grade/Subject:
6
7
8
9
10
11
Teacher:
12
13
14
15
16
Part 1 - Supervised direct teaching/Internship activities with children
(150 minimum hours for the semester)
(i.e., classroom teaching, tutoring one or more students, group instruction)
Week
Number
Monday
Date
Part 1
TOTAL:
Part 2 – Non-instructional activities/duties with children
Part 2
TOTAL:
Part 1 & 2 – Full-time classroom experience: Part 1 & Part 2 total
TOTAL
HOURS:
(i.e., observation, bus duty, cafeteria duty, coaching)
(300 minimum hours for the semester)
Student Teacher Signature:
Date: