Supervisor/student Log Sheet

SUPERVISOR/STUDENT LOG SHEET

Touro University

Library#24150 MIS#24160 Student Affairs#24250 Basic Science#24300 COP#26500 F/A#24240 Other#________

1310 Johnson Lane

Mare Island, CA 94592

COLLEGE WORK-STUDY PROGRAM WEEKLY EMPLOYMENT RECORD

Work Study Coordinator# 707-638-5280/Fax# 707-638-5262

Pay#________________ Pay Period_____________________________

Due Date__________________________ Payroll Date______________________________

NAME:

SSN#

This is a record of the days and hours each student works. This report is to be submitted to the Work Study Coordinator in accordance with the published schedule. Compute the hours to the lowest half-hour. The student

should understand the policies and procedures applicable to College Work-Study. The direct supervisor, as well as the student is responsible for the accuracy of the hours on this timesheet. You are required to take one half

hour (1/2) break after five (5) hour of work and one (1) hour break after seven (7) hours of work. You must show a break.

WEEK DAY

DATE

TIME IN

BREAK

BREAK

TIME OUT

TOTAL HOURS

SUPERVISOR SIGNATURE

STUDENT SIGNATURE

SUN

MON

TUES

WED

THURS

FRI

SAT

Total # of hours worked for this week__________

WEEK DAY

DATE

TIME IN

BREAK

BREAK

TIME OUT

TOTAL HOURS

SUPERVISOR SIGNATURE

STUDENT SIGNATURE

SUN

MON

TUES

WED

THURS

FRI

SAT

Total # of hours worked for this week__________

WEEK DAY

DATE

TIME IN

BREAK

BREAK

TIME OUT

TOTAL HOURS

SUPERVISOR SIGNATURE

STUDENT SIGNATURE

SUN

MON

TUES

WED

THURS

FRI

SAT

Total # of hours worked for this week__________

Grand Total Hours__________ X Hourly Wage $__________=$__________

I hereby certify that the above is a true statement of the actual hours and duties worked by the student listed and that the student has performed his/her assigned job in a satisfactory manner.

SUPERVISOR’S SIGNATURE__________________________

DATE_______________