Teacher Extra Service Report Form
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1Jefferson County Public Schools
Teacher Extra Service Report Form
Employee Name: ___________________ Employee Location: ___________________
Date
Time
Detailed Work Description
Worked
Worked
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
From:
To:
All extra service must be approved in advance and should be submitted to the
Principal/Cost Center Manager. Do not submit to the Payroll Department
Employee Signature: ___________________
Date: ___________________
Principal Signature: ___________________
Date: ___________________
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Parent category: Education