Form Attendance

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Training/Events Attendance Sheet

Name of PSA/Partner…………………………………………………..……………….Date: ……………….………………


Activity description/topics covered ………….…………………………………………………………………….…………….
…………………………………………………………………………………………………………………………………………………………….
District………………………………………………Subcounty………………………………………Village………………………………
Name of Agent(s): …………………………………………… Sign………………………………………Tel:…………………………….

No Name Gender Age PWD Contact Signature


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Trainer’s/Staff signature…………………………………………………………….. Position: ……………..Tel. no……


(Responsible person)

Summary: # of Male : ………… # of Female :……… Total:……… # of Refugee ………# of PWD………

PWDs: Visual, Physical, Hearing, Dump


Training/Events Attendance Sheet
Name of PSA/Partner…………………………………………………..……………….Date: ……………….………………
Activity description/topics covered ………….…………………………………………………………………….…………….
…………………………………………………………………………………………………………………………………………………………….
District………………………………………………Subcounty………………………………………Village………………………………
Name of Agent(s): …………………………………………… Sign………………………………………Tel:…………………………….

No Name Gender Age PWD Contact Signature


1

10

11

12

13

14

15

16

17

18

19

20

Trainer’s/Staff signature…………………………………………………………….. Position: ……………..Tel. no……


(Responsible person)

Summary: # of Male : ………… # of Female :……… Total:……… # of Refugee ………# of PWD………

PWDs: Visual, Physical, Hearing, Dump

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