I hereby certify that the number of hours listed above is
correct and that the work assigned has been performed in a
satisfactory manner.
________________________________________________
Job Supervisor’s Signature Date
________________________________________________
Student’s Signature Date
________________________________________________
Faculty Advisor’s Signature Date
Performance Record (Timesheet)
Occupational Internship Program
Monthly Performance Record
Student’s Name
Employed By
Work Station Supervisor
Month of _______________20______
This timesheet is mandated by the State and must be turned in to the Faculty Advisor by the due date (last
day of the month).
DATE
IN
OUT
NO
HOURS
DATE
OUT
NO
HOURS
1
17
2
18
3
19
4
20
5
21
6
22
7
23
8
24
9
25
10
26
11
27
12
28
13
29
14
30
15
31
16
TOTAL HOURS
DUE DATE
CWEE Office
28237 La Piedra Road
Menifee, CA 92584
(951) 672-6752
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1. Did any problems develop on which you would like help?
2. What new jobs, assignments, or procedures did you undertake during this period? (Response required)
3. Describe what you have done toward accomplishing your objectives during this period. (Response required)
4. Other comments