This time sheet serves as part of the verification of your service hours. Keep track of
your hours on this sheet, have it signed by your site supervisor, and return it to
your professor by __________________.

............DATE....HOURS..................DATE....HOURS

1. __________ __________ 16. __________ __________

2. __________ __________ 17. __________ __________

3. __________ __________ 18. __________ __________

4. __________ __________ 19. __________ __________

5. __________ __________ 20. __________ __________

6. __________ __________ 21. __________ __________

7. __________ __________ 22. __________ __________

8. __________ __________ 23. __________ __________

9. __________ __________ 24. __________ __________

10. __________ __________ 25. __________ __________

11. __________ __________ 26. __________ __________

12. __________ __________ 27. __________ __________

13. __________ __________ 28. __________ __________

14. __________ __________ 29. __________ __________

15. __________ __________ 30. __________ __________

TOTAL HOURS _______

I have verified that this student served the hours indicated above.
SITE SUPERVISOR:__________________________________ DATE:____________