Fillable Other Academic Services Time Card- 7129 (Los Medanos College)

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Other Academic Services Time Card- 7129 (Los Medanos College)

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7129 revised 3-20 Contra Costa Community College District
Faculty Variable S
ervice Report-Counseling/Other Academic Service
Print NAME (last name first)
EMPLOYEE ID NUMBER
STATUS
Regular or Tenure Track Contract Employee
Temporary Employee
LOCATION:
CCC
DIST
DVC
SERVICE PERFORMED:
Counselor (Hourly)
Other Academic Service (Hourly check one)
Librarian
Other (Indicate)
Personnel Related Service (Hourly) – Indicate Service & Rate
$
Special Program (Hourly) – Indicate Service & Rate
$
TIME SERVED:
MONTH/YEAR
Position Number
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
(Absence Codes: A-Absent without pay, S-Sick, P-Personal necessity leave, H-Paid Holiday, B-Bereavement leave, I-Industrial Accident or Illness)
EMPLOYEE Signature Certifies as true and correct
Date
Signature of SUPERVISOR Certifies as true and correct
Date
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Other Academic Services Time Card- 7129 (Los Medanos College)

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Completed 2 February 2021

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