Note: Please complete this "Activity Log" and sign below.
Faculty Member (Full Name)
Faculty Member's ID Number:
Faculty Member's Title:
Month/Year:
Project:
Course/Section:
Faculty PID (AC or C suffix only):
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
TOTAL HOURS
I certify that the information recorded on this report is a true representation of the actual hours I worked for this project.
Signature of Employee:
Signature of Supervisor:
Date:
Day Description of work performed
Printed Name of Employee:
Printed Name of Supervisor:
Hours
Date:
LOS MEDANOS COLLEGE
TIME & EFFORT CERTIFICATION ACTIVITY LOG
click to sign
signature
click to edit
click to sign
signature
click to edit