HOST TEACHER/STUDENT OBSERVER
AGREEMENT/ATTENDANCE SHEET

Semester/Year _________________________________________________________________

Course Name/Number ___________________________________________________________

In accordance with the guidelines set by SUNY Orange, the following observation times have been agreed upon by both the Host Teacher and Student Observer:

Student	___________________________________________________________________

Observation Site	______________________________________________________________

Host Teacher	______________________________________________________________

This Agreement/Attendance Sheet is an official document of SUNY Orange. Sign, in ink, each time the student observes. Student must submit to his or her instructor at the end of observations.

Date
Times
In/Out
Total 
Hours
Teacher Signature
Student Signature
















































































Circle one (1) and check total hours are met:

Intro to Early	Social and		Observation and	Infant and Toddler	
Childhood		Philosophical	Assessment		Development
10 Hours		10 Hours		24 Hours		32 Hours

Revised 08/03/10