Field Visit Report

Field Visit Form

 

Student Name:             __________________

Project ID:                      __________________

Mentor Name:              __________________

Intern ID:                        ___

Date of the Visit:           ________

Suggested/Referred By: _________________________________

Visit No.: ____

If more Trips required to the same organization:   Yes/No

 

Goal of the visit:

1. ______________________________________________________

2. ______________________________________________________

3. ______________________________________________________

 

Goals Met:

1. ______________________________________________________

2. ______________________________________________________

3. ______________________________________________________

Persons Met(*)

1. Name:            _________________________________________

Duration and Timings of Discussion:    _______________________

Details of the Discussion: ______________________________________________________

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2. Name:            _________________________________________

Duration and Timings of Discussion:    _______________________


Details of the Discussion: ______________________________________________________

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3. Name:            _________________________________________

Duration and Timings of Discussion:    _______________________

Details of the Discussion: ______________________________________________________

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*Add more as needed by attaching more pages in same format