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TO BE COMPLETED BY THE PARTICIPANT
Please circle the dates that your class is scheduled to meet for the month. After each class meeting, fill in the number of hours that you attended class, labs, or other activities required for the class. If you were not in class, please use one of the codes listed below to explain why you were not in class on that date.
Please sign the form and have the Instructor (or designee) sign the form to confirm that the information is correct.
Attendance Month: ________________ 20___ ___
1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31 Attendance Codes: A: Absent C: Closed H: Holiday
Participant’s Signature ________________________
Date: ______________________________________ COMMONWEALTH OF VIRGINIA
VIEW SNAP E&T
DEPARTMENT OF SOCIAL SERVICES
Participant’s Name: _________________ EMPLOYMENT SERVICES PROGRAM
Case #: __________________________
ESW: ____________________________
ESW Phone #: _______ ______________
EDUCATION AND TRAINING ACTIVITIES ATTENDANCE SHEET
This form must be returned to the Employment Services Worker (ESW) by the 5th of every month.
Name of Class: _________________ Name of Program/Curriculum: _________________ Name of Institution: _____________ Instructor Name: _____________________________ How is instruction delivered: In-person Online Hybrid Other: ______________
TO BE COMPLETED BY THE INSTRUCTOR
Is homework/study time necessary for success in this class?
Yes No
Is the attendance information reported accurate? Yes No
Instructor’s Signature: TO BE COMPLETED BY THE (ESW)
Homework/Study Hours 1 2 3 4 5 6 7
8 9 10 11 12 13 14
15 16 17 18 19 20 21
22 23 24 25 26 27 28
29 30 31 Monthly total homework/study hours:
Total attendance hrs: _________ Assigned hrs: __________ Holiday hrs used: ______ Excused absences hrs used: ____ 032-02-1020-05-eng