Community Service / Work Experience

Two-Week Time Sheet

Complete and return to DCF no later than 5 days after the end of the two-week period.

Pay Period Start Date:	Pay Period End Date:

Participant Name:	Client ID #

DCF Career Navigator:	Career Navigator Phone #

Work Site:	Number of Hours to be Worked Per Week:

Site Address:

Site Supervisor:	Site Supervisor Phone #

ENTER NUMBER OF ACTUAL HOURS WORKED EACH DAY

Week 1	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Total Hours
Date
Hours	0
Week 2	Sunday	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Total Hours
Date
Hours	0
Total Pay Period Hours	0

Timesheets should only reflect actual hours worked.

PROGRESS REVIEW

Supervisor: Complete at end of pay period and review with participant.

Above Average	Average	Below Average	Unacceptable
Quantity of Work
Quality of Work
Attitude
Attendance

Duties/Skills Performed
Comments/Recommendations

I certify these hours are true and correct.

Participant Signature:	Date:

Site Supervisor Signature:	Date: