Experiential Learning Timesheet

Experiential Learning Timesheet

Only submit your timesheet after completing your hours for the month!
Internship/Co-op Site Name*
Student Name*

First NameLast Name
Student Email*
Phone Number*
Supervisor Name*

First NameLast Name
Supervisor Email*
Phone Number*

This timesheet is for the month of*
What semester is this for?
Is this a RESUBMISSION of a previously submitted timesheet?*

YesNo
Please acknowledge: If you work 6 or more hours in one shift, you must take at least a 30-minute break. This is NOT counted towards your hours total.*

I understand that if I work 6 hours or more in one shift, I must take at least a 30-minute break.

Internship/Co-Op Shifts *

Student Signature*

Clear
Please acknowledge: By signing above I acknowledge and certify that the information contained on this document is true and accurate.*

I affirm that the hours and information I provided in this timesheet are accurate.
Should be Empty: