KI BOIS HEAD START - DOC by cYevV8B

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									                                             KI BOIS HEAD START
                                         PERSONNEL ACTIVITY REPORT
CENTER____________________________               MONTH_______________________________
NAME_____________________________________________TITLE_________________________________

                 DATE                                            DETAILED DESCRIPTION OF WORK

    SUN
   MON
    TUE
   WED
   THUR
    FRI
    SAT
    SUN
   MON
    TUE
   WED
   THUR
    FRI
    SAT
    SUN
   MON
    TUE
   WED
   THUR
    FRI
    SAT
    SUN
   MON
    TUE
   WED
   THUR
    FRI
    SAT
    SUN
   MON
    TUE
   WED
   THUR
    FRI
    SAT
*Examples: Home visit (Name of family), Taking child/family to service, pick up supplies, Training, Parent Meetings.

I CERTIFY THAT THE ABOVE IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE
                                                 ___________________________________________________
                                                                          EMPLOYEE
I CERTIFY THAT I HAVE FIRST HAND KNOWLEDGE OF THE ACTIVITIES PERFORMED BY THE EMPLOYEE AND
THAT THE ABOVE REPRESENTS A REASONABLE ESTIMATE OF THE ACTUAL WORK PERFORMED DURING
THE PERIOD.                                     _________ _________________________________
                                                                          SUPERVISOR
KHS-918A-09

								
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