Tutor Log Form

Name*
First Last
Work Supervisor's Name: Sarah Hebert
Department of Employment: Library
Pay Period Beginning*
MM slash DD slash YYYY
Pay Period Ending*
MM slash DD slash YYYY
Sessions Logged*
Student's Name Subject Covered Date (mm/dd) Time In Time Out Total Time Notes
Total Hours Worked This Pay Period:*
I certify that the hours worked during the above mentioned payroll period are correct and that this work has been performed in a satisfactory manner.
Tutor Signature

Student's Name	Subject Covered	Date (mm/dd)	Time In	Time Out	Total Time	Notes