Senior Project Hours Verification Form

Completed forms must be given to the mentor and will be provided to the review panel.

Student’s name: Zachary Simbajon

On-campus mentor’s name: Mr. Franklin Gonzales

Group members:
__________________________________N/A___________________________________________

Off-campus mentor’s name (if applicable):

______________N/A_________________________________________

Off-campus mentor’s phone number: ____________N/A_________ E-mail:

_________N/A_______________________

Date Hours Description of Work/Progress

8/2/18 12 Served as a mission staff assistant to the Incident Command Team, doing whatever
tasks would allow adult team members to keep up with phone calls, correspondence
and customer requests.
8/3/18 12 Served as Mission Radio Operator for the Incident Command Post. I maintained
communication between the Incident Command Post and the Maui Ground
Photography Team in order to monitor the status of their operations, their location and
their welfare.
8/4/18 6 Served in the Ground Photography Team on the Big Island, gathering photographic
evidence of the flash-flood impact resulting from Hurricane Lane.
Total hours: _________________

By signing below, all parties attest that the above information verifying the student’s participation is true and
accurate.
___________________________________________ ___________________________________________
Student’s Signature/Date Supervisor’s Signature/Date