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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: 25 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