HTML Preview Daily Attendance Sign In Sheet page number 1.


Provider:
Month, Year:
Child's Name:
Date
Time In Authorized Signature Time Out Authorized Signature
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Daily Attendance Sheet
N:\ReimbursementFiles\Forms\DailyAttendanceSheet\OptionA
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I verify the information on this Daily Attendance Sheet is true and accurate.
Eligible Parent/Guardian Signature Date
Please indicate program by checking the appropriate box below upon completion of the month, prior to submission to PHELC.
VPK SR
N:\ReimbursementFiles\Forms\DailyAttendanceSheet\OptionA
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