Fayetteville State University

Division of Academic Affairs – University College

Supplemental Instruction – Student Attendance Verification Form

Project Funded by Title III

SI Leader:  ____________________________  Course and Section:  ___________________

Date of Session:  ___________ Start Time:  ______ End Time: _______ Bldg/Rm. ________

Session Debrief: ( What did you do and how did you do it? If no one attended, what did you plan to do?)

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Signature of SI Leader:  ___________________________  Date:  __________________________

This completed form must be submitted each Friday by 5pm to the SI file folder in the University College Learning Center in HTC, room 216C.  SI Leaders will not be paid if these forms are not submitted.