Marywood University Scranton, Pennsylvania Department of Nutrition, Athletic Training and Exercise Science Intern Hour Reporting Form Complete this reporting form after each rotation or part ofa rotation. Required Hours in: © ND 565: Community Nutrition ~ minimum 256 hours ND 566 : Food Systems Management ~ minimum 280 hours NDS68: MNT © Long Term Care ~ minimum 144 hours © Acute Care ~ minimum 288 hours Professional Practice following MNT: 128 hours + CHOICE: 64 hours {fonly a fraction of the required hours were completed at a facility —please indicate that amount of hours accomplished, Intern: Oe wee has completed __ (7 47 _ hours forthe CHD ICE tation. Preceptor Signature’ Zhe Aig Intern Signature: Mp Z