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Run: Internship and Externship Hours and Wage Time Log

Track internship and externship hours, wages, and supervisor sign-off in one log built for work-based learning credit and certification. Use it to document e...

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Student and Program Information

Student ID (required)

Enter the school-assigned student identifier. Do not enter SSN or other unnecessary PII.

Student Name (required)

Enter the student's full name as used by the program.

Program Type (required)

School or Program Name (required)

Worksite / Placement Site (required)

Log Entry Details

Work Date (required)

Start Time (required)

End Time (required)

Unpaid Break Minutes

Enter unpaid break time, if any.

Total Hours Worked

Work Performed / Learning Activities (required)

Briefly describe the tasks, projects, or learning activities completed during this session.

Wage and Compensation

Is this placement paid? (required)

Hourly Pay Rate

Enter the hourly wage only if the placement is paid.

Compensation Type

Wage Notes

Add any reporting notes about pay structure or wage adjustments.

Supervisor Verification

Supervisor Name (required)

Supervisor Title

Supervisor Email

Optional contact field for verification follow-up.

Supervisor Signature (required)

Verified Hours (required)

Confirm the total hours approved for this session.

Student Attestation and Submission

I certify that this log is accurate to the best of my knowledge. (required)

Yes No N/A

I understand this information will be used to track WBL hours, credit, and certification records. (required)

Yes No N/A

Additional Notes

Optional notes for the program coordinator. Do not include sensitive personal information.

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Email (required)

Your name (optional)

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