4 Cooperative Education Time / Wage Report

Download a Word Document file of this report here.

COOPERATIVE EDUCATION

TIME/WAGE REPORT

In order for a co-op student to receive academic credit, an account of time and days worked on the job must be recorded by the student and verified by the supervisor. This information will be kept confidential.

Student name:­­­­­­­­­­­­­­­­­­­­­­­_____________________________ Employer  __________________________________

Month__________________                Year___________________

Weeks S M T W TH F S Total hours
Monthly Total

Summary of monthly tasks performed:_____________________________________________________

____________________________________________________________________________________

I certify that the above time report is a true statement             I certify that the above time report is a true

of the hours worked this week                                                    statement of the hours worked this month.

__________________________________________     ______________________________________

Student Signature                               Date              Employer Signature                Date

Month_________________________________            Year__________________

Weeks S M T W TH F S Total hours
Monthly Total

Summary of monthly tasks performed:_____________________________________________________

____________________________________________________________________________________I certify that the above time report is a true statement                       I certify that the above time report is a true                               of the hours worked this month.             statement of the hours worked this month.

_________________________________________       ______________________________________

Student Signature Date                                               Employer Signature Date

 

Student name:­­­­­­­­­­­­­­­­­­­­­­­_____________________________ Employer  __________________________________

Month__________________                Year___________________

Weeks S M T W TH F S Total hours
Monthly Total

Summary of monthly tasks performed:_____________________________________________________

____________________________________________________________________________________

I certify that the above time report is a true statement             I certify that the above time report is a true

of the hours worked this week                                                    statement of the hours worked this month.

__________________________________________     ______________________________________

Student Signature                               Date              Employer Signature                Date

Month_________________________________            Year__________________

Weeks S M T W TH F S Total hours
Monthly Total

Summary of monthly tasks performed:_____________________________________________________

____________________________________________________________________________________I certify that the above time report is a true statement                       I certify that the above time report is a true                               of the hours worked this month.             statement of the hours worked this month.

_________________________________________       ______________________________________

Student Signature Date                                               Employer Signature Date

 

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