Part-time Coach (non-accruing) Monthly Attendance Record

Office of Human Resources and Payroll
dlooney@brockport.edu

1Employee Details and Certification > 2Supervisor Certification
Submit this form to the Payroll Office no later than the fifth (5th) day of the month following the reporting month.
Attendance Record for Month of
Attendance Record for Year of
Name - Employee Name - Employee First Last
Email - Employee
Name - Supervisor Name - Supervisor First Last
Email - Supervisor
EMPLOYEE CERTIFICATION OF ATTENDANCE FORM
Employee: Select the button to indicate your agreement with the statement.

Employee: Select the button to indicate your agreement with the statement. I certify that I was present and performed my work obligations as required throughout the month.
Employee: Type your full name in the box below as legal representation of your signature.
Date signed Date signed / MM / DD YYYY
SUPERVISOR NEXT STEP:
1. Select the "Continue" button below to proceed to the next page.
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