Senior Project Hours Verification Form

Completed forms must be given to the mentor and will be provided to the review panel.

Student’s name: _____________________________________________________________________________

On-campus mentor’s name: ____________________________________________________________________

Group members: _____________________________________________________________________________

Off-campus mentor’s name (if applicable): _______________________________________________________

Off-campus mentor’s phone number: _____________________ E-mail: ________________________________

Date Hours Description of Work/Progress

Total hours: _________________

By signing below, all parties attest that the above information verifying the student’s participation is true and
accurate.
___________________________________________ ___________________________________________
Student’s Signature/Date Supervisor’s Signature/Date