YACADEMY Documentation of Hours Worked Unpaid Internships Only DUE DATE: 5" of the Following Month (unless otherwise noted) Name: Abcam ody Placement Site: Fersight Eye Center Mentor: De. Teveng Title: _O crometyist HOURS MUST BE RECORDED DAILY AND SUPERVISORIMENTOR SIGN DAILY. FALSIFYING RECORDS WILL RESULT IN DISMISSAL FROM THE PROGRAM. PLEASE BE ON TIME AND IN ATTENDANCE DAILY. PLEASE NOTIFY WBL COORDINATOR OF ANY ABSENCES, [ Date Day | Time In Time Mentor if absent, state | Out Signature reason Ten “thes [imon [ake 75 nin Ties Be. Rien Hon sn. tein) 3/7 Ae Taw ins P3minl 3/24/16 | Thee ae rin! > / 18/6 | how Heels J3r/ ie | Ts Ez Mme | WSUS Tht | 41 a wen [Apo fib | on Y (ote Vee seen [M143 AG ners z % Che nm Tox a ee Total Hours AA he Sm Please print first & last names for all mentors’ signatures above. I certify the report above is a correct reflection of hours performed. ay Hakan Warr, Student/intern Signature Mentor/Supervisor Signature TE he 3mm + A4hr Bmin > [124k nin Overall lowesghee Ghe Tee | Deke Dey } Tine Tn u fue Moa | 11 30 sre Hen ; - \