1.Name:

2.Summer work site:
(Name of school)

3.Supervisor name and contact information:

4.Dates you'll be working & hours:
(Example: 6/01-6/30, M-F, 8a-1p)

5.Duties and responsibilities:

6.There is no summer program at my school: 

I will need a summer assignment from my Program Manager.

I will be working at the school planning and providing support.