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C-0013 Sample (Rev 08/11)
DRIVER’S ATTENDANCE LOG
for
Date (month/week of)
Key: / = on Bus X = Off Bus A = Absent Destination:
NAME OF CHILD MONDAY TUESDAY WEDNESDAY THURSDAY FRIDAY
AM PM AM PM AM PM AM PM AM PM
Time of Departure
Time of Arrival
My signature below each date verifies that I have conducted a physical inspection of the vehicle and a visual sweep of the vehicle to ensure that no
child is left in the vehicle. At a minimum, the signature must include first initial and complete last name.
Driver’s signature AM
Staff’s signature AM
Driver’s signature PM
Staff’s signature PM
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