Time Clock Adjustment – Gold Medal Swim School

Form filled out Date and time

Employee Information

First Name*

Last Name*

Clock-In Number

Email*

Adjustment #1

Date*

In Time*

: Hour

Minute

Out Time*

: Hour

Minute

Job Code*

Comments (Optional)

Would you like to add another adjustment?

Yes

Adjustment #2

Date*

In Time*

: Hour

Minute

Out Time*

: Hour

Minute

Job Code*

Comments (Optional)

Would you like to add another adjustment?

Yes

Adjustment #3

Date*

In Time*

: Hour

Minute

Out Time*

: Hour

Minute

Job Code*

Comments (Optional)

Would you like to add another adjustment?

Yes

Adjustment #4

Date*

In Time*

: Hour

Minute

Out Time*

: Hour

Minute

Job Code*

Comments (Optional)

Would you like to add another adjustment?

Yes

Adjustment #5

Date*

In Time*

: Hour

Minute

Out Time*

: Hour

Minute

Job Code*

Comments (Optional)

Would you like to add another adjustment?

Yes

Adjustment #6

Date*

In Time*

: Hour

Minute

Out Time*

: Hour

Minute

Job Code

Optional

Sub Shift
Regular Shift
Missed Punch(es)
Wrong Job Code
Off-Site Practice
Meet/Clinic
Additional Tasks

Comments (Optional)