Intern Supervision Log and Learning Objectives Form

Captures weekly check-ins, learning objectives, projects assigned, and competencies developed during an internship. Used by nonprofit intern supervisors to satisfy academic credit and program requirements.

Log Entry Details

• Date of Supervision Session
  The date on which this supervision session took place.
• Internship Week Number
  Enter the sequential week number of the internship (e.g., Week 1, Week 8).
• Duration of Supervision Session (hours)
  Total time spent in this supervision session, in hours. Used for accrued supervision hour tracking.
• Session Format
  How was this supervision session conducted?
• Cumulative Supervision Hours to Date
  Running total of all supervision hours logged since internship start. Include today's session.

Intern and Supervisor Information

• Intern Full Name
• Intern Email Address
  Intern's academic or organizational email address.
• Academic Institution
  Name of the college, university, or program granting academic credit.
• Academic Program / Degree
  The intern's current degree program.
• Site Supervisor Full Name
• Site Supervisor Title / Role
• Site Supervisor Email Address
• Department or Program Area
  The organizational department or program where the intern is placed.

Learning Objectives and Progress

• Were the intern's learning objectives reviewed during this session?
• Learning Objective 1 — Description
  State the first active learning objective from the intern's learning agreement.
• Learning Objective 1 — Progress This Week
• Learning Objective 2 — Description (if applicable)
• Learning Objective 2 — Progress This Week
  Complete only if a second learning objective is active.
• Learning Objective 3 — Description (if applicable)
• Learning Objective 3 — Progress This Week
  Complete only if a third learning objective is active.
• Supervisor Notes on Objective Progress
  Qualitative narrative to support the progress ratings above. Useful for mid-term and final evaluations.

Projects and Tasks Assigned

• Primary Project or Task This Week
• Task / Activity Categories (select all that apply)
  Select all categories that describe the intern's work this week.
• Additional Tasks or Activities (optional)
• Intern Hours On-Site / Working This Week
  Total hours the intern worked at the placement site this week (not supervision hours).
• Was a deliverable or work product completed this week?
• Describe the Deliverable or Work Product
  Briefly describe the output produced. This may be included in the intern's academic portfolio.
• Attach Work Product or Supporting Document (optional)
  Upload a relevant document, report, or work sample if applicable. Max file size: 10 MB.

Competency Development

• Competencies Demonstrated This Week (select all that apply)
  Select the professional competencies the intern actively demonstrated or developed during this period.
• Overall Competency Development Rating This Week
  Rate the intern's overall professional competency demonstration this week. 1 = Needs significant support; 5 = Exceeds expectations.
• Notable Strength Observed This Week
  Describe a specific, observable strength. Concrete examples are more useful for academic evaluations than general praise.
• Growth Area or Development Need Identified
  Describe a specific area for growth and any planned support or follow-up action.

Check-In Discussion and Follow-Up

• Topics Discussed During Supervision Session
  Select all topics covered in today's supervision session.
• Did the intern raise any concerns or challenges?
• Describe the Concern and Supervisor Response
  Note: Do not include confidential client information or third-party PII in this field.
• Does this concern require escalation to the academic coordinator or program director?
• Action Items and Goals for Next Week
  List specific, observable action items agreed upon for the coming week. These will be reviewed at the next supervision session.
• Next Scheduled Supervision Date
  Date of the next planned supervision session.
• Additional Supervisor Notes (optional)

Attestation and Submission

• Intern Acknowledgment
  The intern confirms the information in this log accurately reflects the supervision session and their work this week.
• Site Supervisor Attestation
  The site supervisor attests that this supervision session occurred as documented and that the information recorded is accurate.
• Site Supervisor Electronic Signature
  Electronic signature of the supervising staff member. This signature satisfies academic program documentation requirements.
• Data Use Notice
  Information collected in this form is used solely for academic program compliance, internship program administration, and organizational record-keeping. PII is handled in accordance with your organization's privacy policy. This form does not collect client or beneficiary information. Retain a copy of each completed log for your internship portfolio and academic file.
• Share this log with the academic field coordinator?
  Most academic programs require supervisors to share supervision logs with the assigned field coordinator each week.