QUARTERLY TIME AND ACTIVITY REPORTING FORM

College Cost Reduction and Access Act
Asian American Native American Pacific Islander-Serving Institution Grant Project

This form should be completed and submitted to the Project Director, Mae Lee (x8973, MCC-21), within 7 days after the end of the quarter. It serves to confirm payroll fiscal records for all grant-supported activities.

ACADEMIC YEAR: 				   ACADEMIC QUARTER: 				

Last Name: 	         	                       First Name:     	  		
Position Title in Relation to Grant:  	Faculty Partner – Instructor of First-Year Experience (FYE) Program	 

Main Activities Completed During Quarter (Summary or bulleted items are fine)

Total Hours Per Quarter = 			

I certify that the information above is correct.

Employee Signature			Date		

Signature: Employee’s Dean		Date		Signature: Grant Project Director		Date