STATEWIDE PARENT ADVOCACY NETWORK
NAME: _______________________________________________________________
SOCIAL SECURITY NUMBER: ON FILE
FOR THE TWO WEEKS ENDING: __________________________________
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DATE (week 1) |
NO.
of Hours
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GRANT(S) |
DATE
(week 2) |
NO.
of Hours
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GRANT(S) |
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HRS
GRANTS
HOURS WORKED: __________
+ Vac. Time Used __________
+ Sick Time Used __________
+ Comp Time Used __________
+ Holiday Time __________
+ Other: _________ __________
HOURS PAID: __________
UNPAID HOURS: __________
Employee Signature: _______________________________________
Supervisor Signature: ______________________________________