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HA invoice - Bridge Other

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Host Advisor Name:
Host Trainee Name:
Date:

Activity	Activity Date Completed	Invoiced
Performance Program Evaluation		$70.00 USD
Practical Program Evaluation		$140.00 USD
Application		$75.00 USD
Orientation		$50.00 USD
Advising Meeting 1		$105.00 USD
Advising Meeting 2		$105.00 USD
Case Study Reports (4)		$25.00 USD per report ($100.00 USD total)
Practice Practical		$200.00 USD
Practice Performance		$100.00 USD
Observed Teaching		$70.00 USD per hour (only 5 allowed)
Extensions		$100.00 USD
	Total invoiced:	$

*If there are two examiners for the exams, the examiners will have to split the amount available for payment. This would include if a HA sits in with a LTT. The HA will receive payment too. Who completed the exam needs to be reported on the monthly report.

Once invoice is received it could take up to 45 days to receive payment.

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Timestamp

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2017-02-07 13:20:28 MDT

HA invoice - Bridge Other Uploaded by Rachel Taylor Segel - forms@thepilatescenter.com IP 50.194.156.193