ACCHS Work Placement Attendance Record v1.0 Dec2022
ACCHS Work Placement Attendance Record v1.0 Dec2022
ACCHS Work Placement Attendance Record v1.0 Dec2022
Student’s name:
Qualification:
Workplace name and
location:
Instruction to the student: The following table must be completed each and every day you attend work placement.
Ensure your Workplace Supervisor initials each day you are present and signs in the space below. This completed form
is to be submitted to your Trainer and Assessor or field coordinator at your first day back at training. A total of 120 hours
of work placement must be completed throughout the duration of your course as per your course schedule. You will
need to submit more than one form.
Total
Work hours for Workplace
Placement Date Time In Time Out Lunch Time In Time Out day Supervisor
Days (excluding initials
lunch)
Mon 01/01/11 9.00am 12.30pm 30 min 1.00pm 5.00pm 7.5 SP
Date:
Date:
Course Code: