HERBERT H. LEHMAN COLLEGE OF THE CITY UNIVERSITY OF NEW YORK 

TEACHING INSTRUCTIONAL STAFF MONTHLY 
ATTENDANCE REPORT 

DEPARTMENT: 
(text) 
MONTH OF: 
(text) 


ABSENCES: (Report reasons for absences below) 

NAME 
DATES OF ANNUAL SICK UNSCHEDULED OTHER 
ABSENCE LEAVE LEAVE HOLIDAY 
(text) 
(text) 
(text) 
(text) 
(text) 
(text) 
(text) 


DATE 
EMPLOYEE SIGNATURE 
(text) 
(text) 


DATE 
DEPARTMENT CHAIR/SUPERVISOR