OJT/ PRACTICUM DAILY TIME SHEET

NAME OF TRAINEE:
COURSE/QUALIFICATION:
AGENCY/COMPANY:
ON-SITE SUPERVISOR:
FOR THE MONTH OF:
AM PM NO. OF HOURS
DATE (BREAKTIME NOT
TIME IN TIME OUT TIME IN TIME OUT INCLUDED)

TOTAL NO. OF HOURS

SUBMITTED BY: CERTIFIED CORRECT BY:

_________________________ _________________________
Trainee’s Signature On-Site Supervisor’s Signature
Date: ____________________ Date: ____________________

Date: _________________________