Internship Activity Report

(To be completed by the student intern)



Student Intern's Name:
Please enter today's date:
Report number:
Communication with supervisor:
Physical well being (food, lodging, general health):
Opportunity to learn and practice skills:
Your level of satisfaction with this experience so far:

Assumed level of satisfaction of the experience provider:

Cooperation with fellow workers:
Please rate your work speed:
Please tell me your level of ability to handle responsibility:
How are you handling suggestions from supervisors?
What level of technical competence have you achieved?
In the following boxes, please list jobs or duties you have been performing. Indicate how many hours you have spent on each job, and what level of proficiency you have achieved:
Additional job or duty:
Additional job or duty:
Are you keeping a daily journal of your experiences?

Please enter the number of hours worked during this report period:

Please indicate number of hours/days absent from duty, and explain reason for absence.  Please remember to clear any absence with your supervisor, and the department coordinator.
Firm name and address:
Owner/Supervisor name:
Phone number:
Your preferred email address (not the employers):


If it does not submit, please print or save this form and send it to: Blake Willis, 239 BEN or



Applied Plant Science Department

Rexburg, ID 83460-1110

(208) 496-2018