Community-Based Learning Research Work Log

PLEASE PRINT CLEARLY! We need to be able to read your info so we can contact you if

necessary

Student Name: ________________________________________________________________

Email: _______________________________________________________________________

Home Phone: ___________________________ Cell Phone: ___________________________

Course: _______________________________ Professor: _____________________________

Description of Action/Work

Duration/

Validating

Date

Completed

# of Hours

Signature

If you are interviewing someone, they can sign off as the validating signature. If you do not have

a witness to your work other than yourself, then you may sign off on your own time log. Honesty

is of utmost importance.

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Parent category: Miscellaneous