Stockbridge High School s1

Henry county schools WORK-BASED LEARNING PROGRAM Wage and Hour Report for the week of Feb 28 - Mar 05, 2016

Name ______ID #______

Employer______Supervisor______

GRADING SCALE: REMINDER:  Return on MONDAY for a grade of 100.  Return on TUESDAY for a grade of 90. . Transfer totals to your Monthly  Return on WEDNESDAY for a grade of 80. Summary Report.  Return on THURSDAY or FRIDAY . Points WILL BE DEDUCTED for a grade of 70. for incomplete information.  LATE return for a grade of 50.

SCHOOL ATTENDANCE TOTAL DAY DATE HOURS SCHEDULED (circle Present or Absent) HOURS Sunday 02/28 ------In Out Monday 02/29 Present Absent In Out Tuesday 03/01 Present Absent In Out Wednesday 03/02 Present Absent In Out Thursday 03/03 Present Absent In Out Friday 03/04 Present Absent In Out Saturday 03/05 ------In Out TOTAL HOURS WORKED

S U M M A R Y

______X ______= ______(Rate of Pay) (Total Hours) (Total Pay – including tips, etc…)

Note to Teacher (if necessary):

______

updated Dec 2012 – sb Henry county schools WORK-BASED LEARNING PROGRAM Wage and Hour Report for the week of March 06 – 12, 2016

Name ______ID #______

Employer______Supervisor______

SCHOOL ATTENDANCE TOTAL DAY DATE HOURS SCHEDULED (circle Present or Absent) HOURS Sunday 03/06 ------In Out Monday 03/07 Present Absent In Out Tuesday 03/08 Present Absent In Out Wednesday 03/09 Present Absent In Out Thursday 03/10 Present Absent In Out Friday 03/11 Present Absent In Out Saturday 03/12 ------In Out TOTAL HOURS WORKED

S U M M A R Y

______X ______= ______(Rate of Pay) (Total Hours) (Total Pay – including tips, etc…)

Note to Teacher (if necessary):

______

updated Dec 2012 – sb Henry county schools WORK-BASED LEARNING PROGRAM Wage and Hour Report for the week of March 13 – 19, 2016

Name ______ID #______

Employer______Supervisor______

SCHOOL ATTENDANCE TOTAL DAY DATE HOURS SCHEDULED (circle Present or Absent) HOURS Sunday 03/13 ------In Out Monday 03/14 Present Absent In Out Tuesday 03/15 Present Absent In Out Wednesday 03/16 Present Absent In Out Thursday 03/17 Present Absent In Out Friday 03/18 Present Absent In Out Saturday 03/19 ------In Out TOTAL HOURS WORKED

S U M M A R Y

______X ______= ______(Rate of Pay) (Total Hours) (Total Pay – including tips, etc…)

Note to Teacher (if necessary):

______

updated Dec 2012 – sb Henry county schools WORK-BASED LEARNING PROGRAM Wage and Hour Report for the week of March 20 – 26, 2016

Name ______ID #______

Employer______Supervisor______

SCHOOL ATTENDANCE TOTAL DAY DATE HOURS SCHEDULED (circle Present or Absent) HOURS Sunday 03/20 ------In Out Monday 03/21 Present Absent In Out Tuesday 03/22 Present Absent In Out Wednesday 03/23 Present Absent In Out Thursday 03/24 Present Absent In Out Friday 03/25 Present Absent In Out Saturday 03/26 ------In Out TOTAL HOURS WORKED

S U M M A R Y

______X ______= ______(Rate of Pay) (Total Hours) (Total Pay – including tips, etc…)

Note to Teacher (if necessary):

______

updated Dec 2012 – sb Henry county schools WORK-BASED LEARNING PROGRAM

Wage & Hour Report for the MONTH of: MARCH 2016

Name ______ID # ______

Employer ______Supervisor ______

Describe ways in which you are an effective communicator at work. ______

Total Gross WEEK OF: Rate of Pay Hours Pay 02/28 – 03/05 $ . 03/06 – 03/12 $ . 03/13 – 03/19 $ . 03/20 – 03/26 $ .

$ . MONTHLY TOTALS $ .

Submit this form to your WBL Instructional Leader for grading GRADING SCALE: *If you are an unpaid intern, please have your supervisor sign below  Return on MONDAY for a grade of 100. verifying that your monthly total  Return on TUESDAY for a grade of 90. hours are correct.  Return on WEDNESDAY for a grade of 80.  Return on THURSDAY or FRIDAY for a grade of 70.  LATE return for a grade of 50. Employer’s Signature  50 point deduction— no check stub attached if paid Or no employer signature if unpaid. Points WILL BE DEDUCTED for incomplete information.