MM/DD/YY
Week Day SUN MON TUE WED THU FRI SAT
Hours
Worked
MM/DD/YY
Week Day SUN MON TUE WED THU FRI SAT
Weekly Total
X $10.25 (Hourly Wage)
Note: Weekly total not to exceed 15 hours.
ON-CAMPUS TIME SHEET
Pay Period Beginning Date
Pay Period Ending Date
INSTRUCTIONS: Time sheets must be completed and submitted to the Work Study Coordinator in the financial aid office according to the Work
Study Payroll Schedule and instructions. Late time sheets may not be processed until the following payroll period. Late time sheets must be
submitted no later than a 30-day period from the time work was performed.
The Work Study Program (WSP) will not be responsible for time sheets for the current award year which are received after the last day. DO NOT
REPORT ESTIMATED OR FUTURE HOURS.
Supervisors must complete and submit signed original copy to: Work Study Coordinator, Room 1359, (708) 709-3913.
PLEASE TYPE OR PRINT
Student's Name (Last, First, M.I.)
Student ID Number
Full Department Name
STUDENT INFORMATION
EMPLOYER INFORMATION
Office Number
Work Study Supervisor
Phone Number
Student's Signature Date
STUDENT - I hereby certify that this time sheet is a true and correct statement of the hours
worked by me.
Supervisor's Signature Title
RECORD OF ACTUAL BIWEEKLY HOURS WORKED BY CALENDAR DAY
WEEK 1
WEEK 2
OFFICE USE ONLY
Processor Signature
SUPERVISOR - I certify under penalty of perjury that this time sheet is a true and correct
statement of time worked by this student. I further certify that work was done in a satisfactory
manner.
Weekly Total
Total Hours
Hours
Worked
Time In/Out
Time In/Out
