AR 342.2 (Exhibit) Homebound Instruction Time & Mileage

  • AR342.2 Exhibit

     

                                                                                                     ___________________________________

    Name of Student 

    ___________________________________

    Name of Building Homebased Instructor

     

    HOMEBOUND INSTRUCTION

    - TIME & MILEAGE -

     

    Please complete in triplicate and submit to your building principal by the last Friday of the month.  Thank you.

     


     

          DATE                    SUBJECTS                     ACTIVITY           TOTAL HOURS   TOTAL

                                                                                                                        (per session)       MILES

     

    __________      a.                                                                                    _____________     _________

                              b.

                              c.

     

    __________     a.                                                                                     _____________     _________

                             b.

                             c.

     

    __________     a.                                                                                     _____________     _________

                             b.

                             c.

     

    __________     a.                                                                                      ____________      _________

                             b.

                             c.

     

    __________     a.                                                                                     _____________     _________

                             b.

                             c.

     

    __________     a.                                                                                     _____________     _________

                             b.

                             c.

     


     

    __________     a.                                                                                     _____________     _________

                             b.

                             c.

     

    _________       a.                                                                                     _____________     _________

                             b.

                             c.

    _________________________________________________________________________________

    FOR OFFICE USE ONLY

    Total Hours Employed:  _______________      Total Hours Traveled:  _______________________

     

    Labor Acct. #  _______________________   Mileage Acct. #  ____________________________

     

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