Moonlighting Timesheet

Reminder: Please complete and submit this timesheet for moonlighting shifts for the H02B PICU, OSU NICU, Admitting Senior, and Back-up Moonlighter. For shifts in the ED and H08B PICU, please report your hours directly to the department.

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 First Name: Resident Last Name: Email Address Employee Number (on Nationwde Children's badge): Date of Moonlighting shift: Location of Moonlighting Shift: Hours of Moonlighting shift:

If other hours selected

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.

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Moonlighting Timesheet