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Institute for Clinical Social Work 401 South State St. Suite 822 Chicago, IL 60605

T (312) 935-4232 F (312) 935-4255

Practicum Monthly Time Sheet Month of:_ Student Name: Field Practicum Location: Practicum I

Practicum II

Please record the total number of daily hours you reported for work at your agency. For example, a 9-5 day is a credit of eight hours, regardless of the type of activities that you performed. However, travel to and from the agency is not counted in the total hours or your lunch hour. Practicum I placements require a minimum of 350 hours and Practicum II placements requires 700 hours. Date

Start Time

End Time

Total Hours for the Month Student’s Signature and Date __________________ Field Instructor’s Signature and Date ____________

Total Hours

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Field Placement Practicum  

Field Placement Practicum  

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