Moonlighting Timesheet

NOTICE: This timesheet must be submitted within 24 hours of completing your shift to ensure that the moonlighting pay will appear on your next paycheck.
Resident Name: *
Date of Moonlighting shift: *
Hours of Moonlighting shift: *
If other, please use this space to explain why the standard shifts or times do not apply. Please include the location worked, the start time of your moonlighting shift, the end time of your moonlighting shift, and the reason(s) why these hours apply:
By clicking "Submit" below, you are electronically signing that you agree to the below statement.
I attest that I have already worked in this location as a moonlighting resident, during these hours. If this timesheet is not submitted within 24 hours of completing my moonlighting shift, I understand that moonlighting pay may be delayed until after my next paycheck.

Reminder:

Please remember to fill out Moonlighting forms for all shifts for record keeping purposes. However, please remember if you are Moonlighting in the ED you need to make sure you are turning in the additional form required by the ED.