Lesson Verification Form
To be filled by tutors
Instructor Name
First Name
Last Name
Student Name
First Name
Last Name
Student Email
example@example.com
Lessons for:
January
February
March
April
May
June
July
August
September
October
November
December
(month)
Regular Lesson Day
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Lesson
-
Day
-
Month
Year
Date Picker Icon
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
10
20
30
40
50
Minutes
AM
PM
AM/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
Submit
Should be Empty: