Digital Attendance Roster for WSASP Clock Hours

Directions for Completing this Form

Thank you for attending a WSASP event. In order to obtain clock hour documentation, please complete an evaluation form for each of the sessions you attended. After submitting your evaluation forms, complete this form to document your total hours of attendance. After submitting this attendance form, the link to download the WSASP Clock Hour Form will appear. Click this link, download the clock hour form, and print/complete this form to keep for your records. These forms are often used for documenting clock hours for license renewal purposes as well as submitting to human resources for placement on the salary schedule. Questions about clock hours can be directed to the Clock Hour Chair, Amanda Fleck, at clockhours@wsasp.org.

Name*

First Last

Email*

Enter Email Confirm Email

Event Title*

Mode of Attendance*

Date of Attendance*

Clock Hours Available*

How many clock hours are offered for this event?

Providing your signature is necessary for you to receive clock hours and verifies that attended the total number of hours you requested. NOTE: Non WSASP members must pay a fee ($2.00 per hour) for clock hours.

Number of Hours Requested*

How many hours did you attend this event?

Signature*

Membership

Are you an active member of WSASP?*

Yes
No
No but I paid for clock hours with registration

Hours

Price: $0.00