Logbook Page Template

PEG Internship Guideline

Logbook Page

Entry date and

Record of all work – Minimum one entry per month. List employer’s name for

Verification of

number of days

each entry. List supervisor’s employer if not the same as that of applicant

professional

for each entry

EIT/GIT.

member/supervisor

Supervisor’s name in full, address, e-mail and

Name _________________________________

telephone number.

Address ________________________________

NOTE: Each entry must be initialed in the right hand

column by the professional member/supervisor who is

_______________________________________

verifying the activity.

Telephone ______________________________

E-mail __________________________________

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Parent category: Miscellaneous