CAPA-HC Census 2020 Staff/Volunteer Time and Mileage Log

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    Project Title *

    Staff/Volunteer Name: *

    Phone Number

    Email

    Staff/Volunteer Position:

    Paid Staff Person? *

    Hourly Rate:

    Mileage Rate:

    Date of Work *

    Hours: *

    Miles:

    Description of Duties/Work Involved *