Sandhills Community College WCE WBL FORM 3 Rev. 2020
WORKFORCE CONTINUING EDUCATION (WCE)
WORK BASED LEARNING (WBL)ACTIVITY REPORT
Student Name: WBL Class:
Semester:
Work Start Date:
example
MON
TUE
WED
THUR
FRI
SAT
SUN
Dates
8/18/14
Time
1-4 pm
Total
hours
3
I verify this is a true and accurate account of hours worked.
Student Signature: _________________________________________ Date: _________________
Supervisor Signature: _______________________________________ Date: _________________
If the student’s work hours will not begin until after the semester census date, a one-hour orientation
may be substituted to confirm student activity.
Orientation Date:
Student Signature: _________________________________________________ Date: _________________
WBL Coordinator Signature: _________________________________________ Date: _________________
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signature
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signature
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signature
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signature
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