Sample Service Contract and Acknowledgement Receipt
Name: ________________________________________________________________
Address: ______________________________________________________________
Description of Service:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
Date of Service: ____________________ Location of Service: ___________________
Remuneration: _____________________
_____________________________ ______________________________
Signature (Program Coordinator) Signature (Facilitator)
ACKNOWLEDGEMENT RECIPT
Received the amount of _____________________________________________
($___________ ) as payment for ______________________________________
__________________________________________________________________
_____________________________ ________________________
Signature and printed name Date