SAN JOAQUIN DELTA COLLEGE

SAN JOAQUIN DELTA COLLEGE
REPORT OF FLEX ACTIVITY
Assignment Type*
Email*
firstname.lastname@deltacollege.edu
Name*

FIRST NAMELAST NAME
TrAC Department*
DISCIPLINE*

FLEX 1
FLEX REPORTING DEADLINES

SPRING 2026: Monday, April 27, 2026
Date of Activity (FL1):*

MonthDayYear
Date
Select The Flex Category (FL1):*
Description of Flex Activity (FL1):*
Hours (FL1):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 2
Date of Flex Activity (FL2):*

MonthDayYear
Date
Select The Flex Category (FL2):*
Description of Flex Activity (FL2):*
Hours (FL2):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 3
Date of Flex Activity (FL3):*

MonthDayYear
Date
Select The Flex Category (FL3):*
Description of Flex Activity (FL3):*
Hours (FL3):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 4
Date of Flex Activity (FL4):*

MonthDayYear
Date
Select The Flex Category (FL4):*
Description of Flex Activity (FL4):*
Hours (FL4):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 5
Date of Flex Activity (FL5):*

MonthDayYear
Date
Select The Flex Category (FL5):*
Description of Flex Activity (FL5):*
Hours (FL5):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 6
Date of Flex Activity (FL6):*

MonthDayYear
Date
Select The Flex Category (FL6):*
Description of Flex Activity (FL6):*
Hours (FL6):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 7
Date of Flex Activity (FL7):*

MonthDayYear
Date
Select The Flex Category (FL7):*
Description of Flex Activity (FL7):*
Hours (FL7):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 8
Date of Flex Activity (FL8):*

MonthDayYear
Date
Select The Flex Category (FL8):*
Description of Flex Activity (FL8):*
Hours (FL8):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 9
Date of Flex Activity (FL9):*

MonthDayYear
Date
Select The Flex Category (FL9):*
Description of Flex Activity (FL9):*
Hours (FL9):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 10
Date of Flex Activity (FL10):*

MonthDayYear
Date
Select The Flex Category (FL10):*
Description of Flex Activity (FL10):*
Hours (FL10):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 11
Date of Flex Activity (FL11):*

MonthDayYear
Date
Select The Flex Category (FL11):*
Description of Flex Activity (FL11):*
Hours (FL11):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 12
Date of Flex Activity (FL12):*

MonthDayYear
Date
Select The Flex Category (FL12):*
Description of Flex Activity (FL12):*
Hours (FL12):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 13
Date of Flex Activity (FL13):*

MonthDayYear
Date
Select The Flex Category (FL13):*
Description of Flex Activity (FL13):*
Hours (FL13):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 14
Date of Flex Activity (FL14):*

MonthDayYear
Date
Select The Flex Category (FL14):*
Description of Flex Activity (FL14)*
Hours (FL14):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 15
Date of Flex Activity (FL15):*

MonthDayYear
Date
Select The Flex Category (FL15):*
Description of Flex Activity (FL15):*
Hours (FL15):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 16
Date of Flex Activity (FL16):*

MonthDayYear
Date
Select The Flex Category (FL16):*
Description of Flex Activity (FL16):*
Hours (FL16):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 17
Date of Flex Activity (FL17):*

MonthDayYear
Date
Select The Flex Category (FL17):*
Description of Flex Activity (FL17):*
Hours (FL17):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 18
Date of Flex Activity (FL18):*

MonthDayYear
Date
Select The Flex Category (FL18):*
Description of Flex Activity (FL18):*
Hours (FL18):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 19
Date of Flex Activity (FL19):*

MonthDayYear
Date
Select The Flex Category (FL19):*
Description of Flex Activity (FL19):*
Hours (FL19):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 20
Date of Flex Activity (FL20):*

MonthDayYear
Date
Select The Flex Category (FL20):*
Description of Flex Activity (FL20):*
Hours (FL20):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 21
Date of Flex Activity (FL21):*

MonthDayYear
Date
Select The Flex Category (FL21):*
Description of Flex Activity (FL21):*
Hours (FL21):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 22
Date of Flex Activity (FL22):*

MonthDayYear
Date
Select The Flex Category (FL22):*
Description of Flex Activity (FL22):*
Hours (FL22):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 23
Date of Flex Activity (FL23):*

MonthDayYear
Date
Select The Flex Category (FL23):*
Description of Flex Activity (FL23):*
Hours (FL23):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 24
Date of Flex Activity (FL24):*

MonthDayYear
Date
Select The Flex Category (FL24):*
Description of Flex Activity (FL24):*
Hours (FL24):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 25
Date of Flex Activity (FL25):*

MonthDayYear
Date
Select The Flex Category (FL25):*
Description of Flex Activity (FL25):*
Hours (FL25):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 26
Date of Flex Activity (FL26):*

MonthDayYear
Date
Select The Flex Category (FL26):*
Description of Flex Activity (FL26):*
Hours (FL26):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 27
Date of Flex Activity (FL27):*

MonthDayYear
Date
Select The Flex Category (FL27):*
Description of Flex Activity (FL27):*
Hours (FL27):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 28
Date of Flex Activity (FL28):*

MonthDayYear
Date
Select The Flex Category (FL28):*
Description of Flex Activity (FL28):*
Hours (FL28):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 29
Date of Flex Activity (FL29):*

MonthDayYear
Date
Select The Flex Category (FL29):*
Description of Flex Activity (FL29):*
Hours (FL29):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 30
Date of Flex Activity (FL30):*

MonthDayYear
Date
Select The Flex Category (FL30):*
Description of Flex Activity (FL30):*
Hours (FL30):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 31
Date of Flex Activity (FL31):*

MonthDayYear
Date
Select The Flex Category (FL31):*
Description of Flex Activity (FL31):*
Hours (FL31):*
Would you like to add another Flex assignment?*

YesNo
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

FLEX 32
Date of Flex Activity (FL32):*

MonthDayYear
Date
Select The Flex Category (FL32):*
Description of Flex Activity (FL32):*
Hours (FL32):*
Hours Needing Revision:
TO BE COMPLETED BY FLEX COORDINATOR
Comments
TO BE COMPLETED BY FLEX COORDINATOR

Create and submit additional Report of Flex Activity forms via DocuSign as needed.
Total Hours Submitted
Total Hours to Review
VERIFICATION STATEMENT
I certify that I have completed these activities within the timeline specified. I also certify that I received no compensation including a stipend or otherwise for these activities. All activities reported here were completed outside of my regular work week/schedule. In addition, I understand that failure to fulfill my Flex requirements will result in a loss of pay in the form of a payroll deduction.
SIGNATURE*

Clear
TODAY'S DATE:

MonthDayYear
Date
Reviewer Comments
To be completed by Flex Coordinator
Reviewer Signature

Clear
Total Hours Approved by Reviewer
Should be Empty:

REPORT OF FLEX ACTIVITY

FLEX 1

FLEX 2

FLEX 3

FLEX 4

FLEX 5

FLEX 6

FLEX 7

FLEX 8

FLEX 9

FLEX 10

FLEX 11

FLEX 12

FLEX 13

FLEX 14

FLEX 15

FLEX 16

FLEX 17

FLEX 18

FLEX 19

FLEX 20

FLEX 21

FLEX 22

FLEX 23

FLEX 24

FLEX 25

FLEX 26

FLEX 27

FLEX 28

FLEX 29

FLEX 30

FLEX 31

FLEX 32

VERIFICATION STATEMENT