Denise Hogan ILAST Participant Recording Form

If activity addresses more than one category, select corresponding categories and address hours with each category. If only one category applies to the activity, leave category 2 and 3 menus on select category.

Use decimal for under 1 hour and round to the nearest fifteen minutes.

15 minutes=.25
30 minutes=.50
45 minutes=.75 

Be sure to keep a personal copy of your hours. 

When you send the form with reflections, send a separate email with your attachments (related documents, graphics), when required, to ddhogan54@hotmail.com. In that email, indicate title of activity in SUBJECT line of your email. Please send the Accounting Form and email with attachments on the same day.

Name:

Email:

Institute #

Category 1

Time Spent

Category 2

Time Spent

Category 3

Time Spent

Describe Activity

Reflection