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Member:    Site:    Week Beginning:     /   /  Week #:   

  Date Training
Hours
Fundraising
Hours
Service
Hours
Total Tasks/Activities/Comments
Mon.  / 
Tue.  / 
Wed.  / 
Thur.  / 
Fri.  / 
Sat.  / 
Sun.  / 
Weekly Totals        

FOR Americorps STAFF USE ONLY


Date Received: ____/____/________    Initials: ______

Entered on WBRS: ____/____/________    Initials: ______

Last Week
Year to Date
 
New Year To Date        
Total Plan Hours      
Remaining Hours        

I have read and reviewed the above entered information and attest to its validity.
Member Signature:   Date:
Supervisor Signature:   Date: