STUDENT TIME CORRECTION FORM

STUDENT TIME CORRECTION FORM
**STUDENT HAS 48 HRS TO CORRECT TIME AFTER 48 HRS TIME WILL NOT BE CORRECTED**
Student’s First and Last Name*
Date of Incorrect Time Entry*

MonthDayYear
Date
Corrected Time Information:
• Corrected Clock-In Time*
• Corrected Clock-Out Time*
Reason for Correction (Check One & Provide Explanation)*

Forgot to clock in/outSystem error or malfunctionClocked in/out at the wrong time by mistakeOther (please explain)
Student Certification:
I certify that the corrected times listed above are accurate and truthful to the best of my knowledge. I understand that providing false information may result in disciplinary action.
Student Signature*

Clear
Date*

MonthDayYear
Date
Administrator/Instructor Approval*

ApprovedDenied Reason:
Denied Reason*
Administration/Instructor Name*
Instructor Signature*

Clear
Date*

MonthDayYear
Date
Should be Empty: