Report for the month of:
Please list hours in ½ hour increments
Other hours (please list hours for all that apply):
Lesson Focus
Current Specific Goal (Remember: goals must be Specific, Measurable, Action-based, Realistic and Time-bound):
Activities/techniques used to help reach this goal:
Materials:
Challenges:
Successes! (big or small):
Please share these successes with others!
Updates (provide details):
Address:
Phone:
E-mail:
Status (vacation/illness/etc):
Follow up call requested?
Yes
No
Best time to call:
No longer meeting (please contact office)