Campus Supervised Summary and Validation Report
Directions: This report should summarize all Campus Supervised Internship Activities that have been completed. You will document your activities on this form and submit the completed form in your 12th course.
  • The Internship requires a minimum of 150 campus supervised internship activities. These activities should match the candidates’ Internship Plan activities.
  • The intern must use the 38 leadership activities, located in their textbook (pages 22-65) as the starting point for these activities. There needs to be a minimum of 38 Campus- Supervised entries that encompasses the 38 leadership activities and nine competencies. *Educational Technology Leadership candidates must include the 33 ISTETechnology Performance Indicators associated with the eight Technology Facilitation Standards in addition to the 38 principal leadership activities.*
  • All columns are required for completion of form.
State Competency Standard/ISTE Technology Facilitation Standard
Skills and Experience Area/ ISTE Performance Indicator
Date Completed
Time Spent on Activity
Description of Activity
Reflection (250 words or less detailing what you have learned from this activity)

1 hour
Observed Instr. Asst. duties, time and expertise in academic assistance to students.

Complete Federal & State reports (e.g. Child Count, Child Find, System Performance Review and Inprovement)