Out-of-Class Contact

Log Sheet

 

Instructor:____________________              Semester:____________

 

Course:_______________________             Section:______________

 

1. List names of students in your class.

 

2. Record out-of-class contacts with students by placing a tally mark in the boxes next to the student’s name during the appropriate weeks of the semester when students have been seen.  If you have several appointments with individuals during the semester and want to indicate the type of services provided (tutoring, counseling, etc.), use the comment section on the backside of this sheet.

 

3. At the end of the semester, turn sheets in to the secretary in Instructional Services, who will record Special Services contacts.

NAME				WK 1	WK 2	WK 3	WK 4	WK 5	WK 6	WK 7	WK 8	WK 9	WK 10	WK 11	WK 12	WK 13	WK 14	WK 15	WK 16	Tot.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.

 

****PLEASE NOTE: On the bottom of the second page a grand total is needed.****