Biweekly Time Sheet and Report Form 2008-2009
Instructions: Member should record number of hours daily (not times of the day). At the end of each stipend period (by noon on the Friday that ends the stipend period), this form must be signed by the member, approved by the supervisor and then faxed to the State 4-H Office, Attn. Molly Frendo (517-353-4846). After faxing the form, mail the original to: Molly Frendo, State 4-H Office, 160 Agriculture Hall, Michigan State University, E. Lansing, MI 48824-1039, where it will kept on file. Stipend checks and direct deposit notification slips will be mailed by 3 pm on pay date. Members should be certain to keep a copy of the timesheets for their records in order to use them during their quarterly report writing. Name County Date __________________________
4-H Mentor Michigan Initiative
Reset all fields
I verify that the following is a true statement of the hours served for the Explore, Experience, Achieve Through 4-H Mentoring program during the week beginning (Monday) ___________________________ and ending (Sunday) ___________________________.
Monday
Week 1
Training
Fund-Raising
Service
Monday
Week 2
Training
Fund-Raising
Service
Tuesday Wednesday Thursday Friday Saturday Sunday
Tuesday Wednesday Thursday Friday Saturday Sunday
Total
Week 1
Description
0
0
0
Total
0
0
0
Training _______________________________________________________________________________________ Service _______________________________________________________________________________________ Fund-Raising __________________________________________________________________________________
Week 2
Description
Training _______________________________________________________________________________________ Service _______________________________________________________________________________________ Fund-Raising __________________________________________________________________________________
Member Signature Supervisor Signature
Date ___________________________________ Date ___________________________________
MSU is an Affirmative Action/Equal Employment Opportunity Institution _________________________________________________________________________________________________________
Data Summary for This Reporting Period
______ # of potential volunteers contacted ______ # of mentor applications received ______ # of mentors trained ______ # of mentors matched ______ # of potential mentees trained ______ # of mentees matched ______ # of partner/collaborator contacts ______ # of partners/collaborators added to the program ______ # of educational activities held for program participants ______ # of potential mentees identified ______ # of publicity articles written ______ # of presentations scheduled ______ # of presentations given ______ # of other promotional activities planned ______ # of other promotional activities held ______ # of service projects planned ______ # of service projects conducted ______ # of social activities held for program participants
In the space below, provide more detailed information on the recruitment activities you have been involved in during the past two weeks (volunteer, partner and/or youth).
In the space below, provide more detailed information on the service activities you have been involved in during the past two weeks (including development of program resource materials, planning or implementation of community service activities, trainings planned or conducted, presentations given, other promotional efforts, etc.).
What training did you attend during this time period? How has it helped you as an individual and as an AmeriCorps member?
What work have you done during the past two weeks as a part of building or strengthening a mentoring collaborative in your community?
What did you accomplish during this time period of which you are especially proud?
What challenges did you experience during this time period? How have you addressed these challenges?
Write down one goal you would like to accomplish over the next two weeks. What steps do you need to take to accomplish this goal?