Semester _______________________

Course # _______________________




HOST TEACHER/STUDENT OBSERVER
AGREEMENT/ATTENDANCE SHEET

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
Time
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