Time & Activity Report1
Department of Public Management and Policy
Andrew Young School of Policy Studies
Georgia State University
PMAP 4941
& PMAP 8941
INTERN INFORMATION
Name:
Agency:
Agency Supervisor:
Credit Hours (3 or 6 w/petition approval):
Report Period (From/To):
Semester Registered for Internship Class:
INTERNSHIP ACTIVITY SUMMARY
Please list your major activities and the percentage of time you spent at each for the duration of
your internship (such as, Research, Interviewing, Reviewing Manuals, and Budget Preparation).
Activity
1
Percentage Of Time
Remember that you can report your work hours in another format if this is easier for you—such as when the
organization where you work has a procedure for tracking your hours. We still want a signature from your
supervisor, of course.
EXPLANATIONS (Tell us anything else we need to know.)
RECORDING AGENCY RELATED ACTIVITY (Use as many weeks as you need.)
On the following pages, please record the work times for each day you worked on your
internship. Record your total hours worked in a week in the far right column of the table.
Once you have completed your internship, indicate total hours of agency activity on the last
page. We leave a space for a signature, and we prefer that you print this form and get your
supervisor to sign this form. If this is not possible, your supervisor can type his or her name,
which we will then consider an official signature.
Complete the boxes below. Uses all the boxes you need.
2
Week Number
And Dates
Mon
Hours
Tues
Hours
Wed
Hours
Thurs
Hours
Week 1
From:
To:
Week 2
From:
To:
Week 3
From:
To:
Week 4
From:
To:
Week 5
From:
To:
Week 6
From:
To:
Week 7
From:
To:
Week 8
From:
To:
3
Fri
Hours
Sat
Hours
Sun
Hours
Total
Hours
Week Number
And Dates
Mon
Hours
Tues
Hours
Wed
Hours
Thurs
Hours
Week 9
From:
To:
Week 10
From:
To:
Week 11
From:
To:
Week 12
From:
To:
Week 13
From:
To:
Week 14
From:
To:
Week 15
From:
To:
Week16
From:
To:
4
Fri
Hours
Sat
Hours
Sun
Hours
Total
Hours
Week Number
And Dates
Mon
Hours
Tues
Hours
Wed
Hours
Thurs
Hours
Week 17
From:
To:
Week 18
From:
To:
Week 19
From:
To:
Week 20
From:
To:
Week 21
From:
To:
Week 22
From:
To:
Week 23
From:
To:
Week 24
From:
To:
5
Fri
Hours
Sat
Hours
Sun
Hours
Total
Hours
TOTAL HOURS OF AGENCY ACTIVITY
YOUR OWN SIGNATURE
INTERN SPONSOR'S SIGNATURE
You may save this form and Email it; send it through regular mail; deliver it
in-person, or fax it: 1-206-203-2056.
Professor Greg Streib
[email protected]
404-413-0116
Professor Katherine Willoughby
[email protected]
404-413-0117
Public Management and Policy
Georgia State University
P.O. Box 3992
Atlanta, GA 30302-3992
Thanks again for providing this opportunity to one of our students. Our internship program has
been extremely successful at satisfying both students and employers, and we appreciate your
help. We encourage you to stay in touch with us and to let us know if you have any questions.
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