Monthly Child Attendance Verification

This form is to be completed by an approved daycare representative and is due by 12 p.m. on the 1st of each month. You may use one form to document attendance for multiple children with the same parent. If one but not all of the children of this student-parent are present on any given date, please select "other" and document this in the space provided.

Facility Name*
Student-Parent Name*
Month*
Attendance*
Insert a new row for each child.
Child Name Days Present Days Absent Days Closed Total Days Accounted For
Comments
*
- I attest that I am an authorized representative of the childcare agency identified above and that I have completed this form honestly and to the best of my knowledge.
Name
This field is for validation purposes and should be left unchanged.

Edgecombe Community College

Childcare Financial Assistance Childcare Vendors

Monthly Child Attendance Verification

Monthly Child Attendance Verification

I attest that I am an authorized representative of the childcare agency identified above and that I have completed this form honestly and to the best of my knowledge.

Child Name	Days Present	Days Absent	Days Closed	Total Days Accounted For