UMA Lesson Verification Form

Lesson Verification Form

To be filled by tutors
Instructor Name

First NameLast Name
Student Name

First NameLast Name
Student Email
example@example.com
Lessons for:
(month)
Regular Lesson Day
Lesson

DayMonthYearHourMinutesAM/PM Option
Content Covered
Notes
Any comments or lesson observations. Explain any irregularities in lesson days and time (e.g. reschedule, student absence, teacher absence)
I hereby verify that the information provided is correct to the best of my knowledge.*

Instructor's Signature Clear
Instructor Email*
example@example.com
Should be Empty: