In the event of sickness it is the student’s responsibility to inform the placement area and the University of Hull Midwifery Programme Secretary Andrea Randerson, phone (01482) – 464583. Module Team Verification Signature Date ……………………………… …………… RECORD OF PLACMENT ATTENDANCE Year 3 Learning Period 1 Student’s Name ….......................................... Student has attended as follows: Hours Mentor Signature Placement Week 1 …..........hrs Week 2 …..........hrs Week 3 hrs ……… Week 4 hrs ……… The student has not attended the placement on the following occasions: Date(s) not Number of hours Number of hours Hours outstanding at end of attended missed made up placement Total number of hours worked of Nights worked (if any)……………… …....................Number Mentor Print name………………………………………………. Mentor’s signature ……………………….................................Date ………………. I verify that the above student has worked 40% of the time within this placement with a sign off mentor on the mentor register. Mentor’s signature Date…………………………… ……………………………………………... Student’s signature………………………………………..…... Date………………………………
In the event of sickness it is the student’s responsibility to inform the placement area and the University of Hull – Midwifery Programme Secretary Andrea Randerson, phone (01482) 464583. Module Team Verification Signature ……………………………… Date …………… RECORD OF PLACMENT ATTENDANCE Year 3 Learning Period 1 Student’s Name ….......................................... Student has attended as follows: Hours Mentor Signature Placement Week 1 …..........hrs Week 2 …..........hrs Week 3 ……… hrs Week 4 ……… hrs The student has not attended the placement on the following occasions: Date(s) not attended Number of hours missed Number of hours made up Hours outstanding at end of placement Total number of hours worked …....................Number of Nights worked (if any)……………… Mentor Print name………………………………………………. Mentor’s signature ……………………….................................Date ………………. I verify that the above student has worked 40% of the time within this placement with a sign off mentor on the mentor register. Mentor’s signature ……………………………………………... Date…………………………… Student’s signature………………………………………..…... Date………………………………