10th Day Form

(To be completed by the student after the first week of work)



Student Intern's Name:
Please enter your address, phone number, and other contact information while on this internship:
Please indicate the number of conferences you have had with your supervisor:
Please indicate the perceived satisfaction of your provider:
What is your level of satisfaction with this experience so far:
Are relations with the provider developing well?
Is your room and board safe and adequate?
On what date did you report for work?

Please describe the kind of duties you have been performing.

Please share three principles that you learned in the classroom, and explain how you have applied them in this work experience.
Firm name and address:
Owner/Supervisor name:
Owner/Supervisor email address:
Your student or preferred Email (how I should contact you):
Phone number:


If it does not submit, please print or save this form and send it to: Blake Willis, 239 BEN BYU-Idaho, or at willisb@byui.edu



Applied Plant Science Department

Rexburg, ID 83460-1120

(208) 496-2018