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Employee Signature Date
Supervisor (print) Signature
Date
Budget Manager (print) Signature
Date
Current
month/
year
P
rior
month/
year
FUND ORGN ACCOUNT PROGRAM
PENAL CODE 72 STATES FALSE OR FRAUDULENT CLAIMS CONSTITUTE
FELONIES. SEE BACK OF CARD FOR FURTHER CONDITIONS.
SICK
HRS
WORK HRS RA
TE # WORK
DAYS
RECORD ALL TIME WORKED IN CORRECT BLOCKS FOR DAYS OF MONTH(S) WORKED
BANNER ID #
POSITION #
M
NAME — LAST FIRST
SUBSTITUTE
FOR _____________________________________________
HR APPROVAL
Rev. 9-15
MARIN COMMUNITY COLLEGE DISTRICT
STUDENT:
Signature on this time card is a declaration of the following:
If you a
re a regular student employee, you are, during a regular class section, maintaining satisfactory progress in
twelve (12) semester units.
If you a
re an Extended Opportunity Program Services (EOPS) student employee, you are, during a regular class
section, maintaining satisfactory progress in nine (9) semester units or equivalency.
If yo
u are a Financial Aids student employee, you are, during a regular class session, maintaining satisfactory progress
in six (6) semester units or equivalency.
If you a
re a Disabled student employee, you are, during a regular class session, maintaining satisfactory progress in
six (6) semester units or equivalency.
SUPERVISOR:
You are the responsible agent of the District. Your signature verifies that the student signing this time card meets the
above stated requirements.
WARNING: Submission of time card by students not meeting above requirement will result in disqualification
from employment eligibility for at least the remainder of current semester.
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