Practicum Start Date:
Practicum End Date:
Total # of Hours or Days Completed:
Supervisor's Full Name:
This survey remains confidential and is not shared with the student.
TASKS Performed by the Student* Please check all that apply:
Capilano University | 2055 Purcell Way, North Vancouver, British Columbia Canada V7J 3H5 Tel: 604.986.1911
Sunshine Coast | 5627 Inlet Avenue, Sechelt, British Columbia Canada V0N 3A0 Tel: 604.885.9310