Quincy University

Illinois Cooperative Work Study Program Employment Log

 

 

 

 

 

Student Employee                                                                                Student Employer                                               

 

_____________________________________                          _______________________________________

Name                                                  Phone Number                          Intern Supervisor                                 Phone Number     

 

__________________________________________                             ____________________________________________

Address                                                                                                    Company

 

__________________________________________                              ____________________________________________

City                            State                          ZIP                                       Address

                                                                                                                   ___________________________________________

___ Fresh     ____ Soph     ____ JR    _____ SR                                      City                                State                             Zip

 

Pay Period Ending (MM/DD/YY):__________________           Hourly Rate to be Paid:  $__________________

 

 

INSTRUCTIONS:  Please fill out completely and return with signature every 2 weeks.  Please review Internship Policies

if you have questions, or call 228-5439.  Hours must be recorded on day worked.  Please record minutes as fractions. 

Example:  4 hours and 15 minutes= 4.25 hours.  Please sign and date at bottom.                                                         

 

Date

In

Out

In

Out

Total

 

Date

 

 

 

 

 

 1

 

 

 

 

 

 

 

 

 

 

 

 

2

 

 

 

 

 

 

 

 

 

 

 

 

3

 

 

 

 

 

 

 

 

 

 

 

 

4

 

 

 

 

 

 

 

 

 

 

 

 

5

 

 

 

 

 

 

 

 

 

 

 

 

6

 

 

 

 

 

 

 

 

 

 

 

 

7

 

 

 

 

 

 

 

 

 

 

 

 

8

 

 

 

 

 

 

 

 

 

 

 

 

9

 

 

 

 

 

 

 

 

 

 

 

 

10

 

 

 

 

 

 

 

 

 

 

 

 

11

 

 

 

 

 

 

 

 

 

 

 

 

12

 

 

 

 

 

 

 

 

 

 

 

 

13