Timesheet Adjustment Request Form

If you missed a clock in or out time for your shift, please use this form to report your actual work hours. Completing this form will ensure that your timesheet is accurately adjusted. *Please complete this form within 72 hours of missed clock in.

Please direct questions regarding Timesheet Adjustments to your Regional Assistant Director:

Snohomish County: Anna-Linnea@premiernwkids.com
Clark County: Liv@premiernwkids.com

Snohomish County Timesheet Adjustment Request Form

Name

First Name

Last Name

Location

Date of Missed Clock-In:

MM

DD

YYYY

Scheduled Shift Start Time:

Please enter the time your shift was scheduled to start.

Hour

Minute

Second

Actual Shift Start Time:

Please enter the time you actually started working.

Hour

Minute

Second

Scheduled Shift End Time:

Please enter the time your shift was scheduled to end.

Hour

Minute

Second

Actual Shift End Time:

Please enter the time you actually finished working.

Hour

Minute

Second

Reason for Missed Clock-In:

Please provide a brief explanation for why you forgot to clock in.

Lead Name:

Please enter the name of a Lead Teacher who can verify your arrival time.

Clark County - Timesheet Adjustment Request

Name

First Name

Last Name

Location

Date of Missed Clock-In:

MM

DD

YYYY

Scheduled Shift Start Time:

Please enter the time your shift was scheduled to start.

Hour

Minute

Second

Actual Shift Start Time:

Please enter the time you actually started working.

Hour

Minute

Second

Scheduled Shift End Time:

Please enter the time your shift was scheduled to end.

Hour

Minute

Second

Actual Shift End Time:

Please enter the time you actually finished working.

Hour

Minute

Second

Reason for Missed Clock-In:

Please provide a brief explanation for why you forgot to clock in.

Lead Name:

Please enter the name of a Lead Teacher who can verify your arrival time.

PNWK Forest School