Employee Name: |
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Position: |
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Start Date of pay Period: |
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End Date of Pay Period: |
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Thu |
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Sun |
Mon |
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Wed |
Working Hours |
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ML, EL, or AD* |
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Holiday |
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Annual Leave |
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Vacation |
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Sick |
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Hospital |
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Bereave- ment |
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Total Hours: |
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Combined: |
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Sat/ |
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Thu |
Fri |
Sun |
Mon |
Tue |
Wed |
Working Hours |
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ML, EL, or AD* |
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Holiday |
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Annual Leave |
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Vacation |
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Sick |
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Hospital |
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Bereave- ment |
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Total Hours: |
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Combined: |
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Overall: |
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PERSONNEL ACTIVITY REPORT |
(Check All That Apply) |
Teacher Duties in HS Classroom |
Assisted in HS Classroom |
Teacher Duties in EHS Classroom |
Assisted in EHS Classroom |
Teacher duties in Child Care Classroom |
Teacher duties in Child Care Classroom |
Teacher Duties in HS Home Base |
Teacher Duties in EHS Home Base |
Drove Bus |
Monitored on Bus |
Cook Duties |
Assisted Parents/Recruitment |
Assisted Staff |
Attended Meeting(s)/Training |
Community Engagement Activities |
Computer Work, Technology |
Phone Calls, E-Mails |
Planning, Budgeting, Grant Writing |
Purchased Supplies |
Reporting |
Hiring |
Reviewed Staff’s Work/Documents |
Trained Staff |
Vision & Hearing |
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Substitutes – will use any of the first five options applicable to the days worked, after one is checked, please write down the dates you subbed for in that position. |
One-On-One Aides – check either Assisted in HS or Assisted in EHS Classrooms. |
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By checking this box, I certify that all information on this form is correct. This checkbox represents my digital signature. |
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Supervisor’s Signature: |
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________________________________________________________ |
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Date: _____________________________ |
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Download PDF |
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