Employee Wellness: Audit class attendance documentation

To be completed by the instructor

Name of student:____________________________________________________

Name of class being audited:__________________________________________

How many weeks does this class meet?__________________________________

How many days per week does this class meet?___________________________

How many hours per day does this class meet?____________________________

How many times has this student been absent from class?____________________

To be completed by the instructor:

How many times has this student been absent from class*? _____________________

Instructor’s name (printed)_____________________________________________

Instructor’s name (signed) _____________________________________________

Contact information (e-mail address or phone)_______________________________

*Total Fitness Students:  Ask your instructor for a print out of minutes of exercise