UNIVERSITY OF BELIZE
BELMOPAN CENTRAL CAMPUS
REMUNERATION
(Field Experience Supervisors)
Lecturer: __________________________________
Course No. and Name: _________________________
Department: _______________________________
Semester: _____________ Academic Year: __________________
( ) Feedback forms for 3 clinical visits have been submitted to coordinator
( ) Assessment forms for 3 graded visits have been submitted to coordinator
( ) Grade sheet with 3 grades and final grade for each student has been
Submitted to coordinator
Supervisor: Date: _________________
Recommended by
Coordinator: Date: _________________
Approved by
Dean: Date: __________________
--------------------------------------------------------------------------------------------------For Official Use Only
To: Accounts Department
HR Director_____________________ Date: __________________
Finance Director__________________ Date: __________________