SPECIAL SERVICES DEPARTMENT

$2 No Mask TIMESHEET : 2021-2022

Classified Employee

NAME: MONTH CYCLE: LAST 4 DIGITS SSN:

Student Name: Employee's Signature: SUPERVISOR SIGNATURE:

DATE 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
JULY H
AUGUST

SEPTEMBER H
OCTOBER

NOVEMBER H H H
DECEMBER H H
JANUARY H
FEBRUARY H H
MARCH H
APRIL H
MAY

JUNE
Date: Duties Performed: Location:
LEGEND: H = HOLIDAYS (DO NOT WORK ON A HOLIDAY) = N/A & = WEEKENDS
By completing the hours list above I confirm:
1. I was in attendance for the hours listed above.
2. The student was in attendance for the hours listed above.
3. The student did NOT wear a mask for the hours listed above while working with me.