Activity Log Cap
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1NORTHWEST REGION CAREER ASSISTANCE PROGRAM (CAP) ACTIVITY LOG
ACTIVITY PERIOD:
NAME:
DCN:
Begin Date:
Estimated End Date:
COMPLETE THE REQUIRED INFORMATION ON THIS FORM AND BRING IT TO YOUR SCHEDULED APPOINTMENT ON
AT
AM
PM
YOU MUST PARTICIPATE IN A MINIMUM OF _____HOURS IN _______________ACTIVITY AND ____HOURS IN ________________ACTIVITY.
ALLOWABLE WORK ACTIVITIES
1 Unsubsidized Employment
4 Alternative/Community Work Experience
7 Job Skills Directly Related to Employment
2 Subsidized Employment
5 Community Service Program
8 Education Directly Related to Employment
3 On-the-Job Training
6 Vocational Education & Training
9 Secondary School/GED
Date
Work Activity
Actual Hours
Starting Location
Ending Location
Total Hours
Distance Traveled to Activity
Begin:
End:
Participant Signature:
Date:
Work Site Coordinator Signature:
Date:
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