Weekly Goal Form

Student—CI Weekly Meeting Report

Week of:__________________________

Strengths:

  1.  
  2.  
  3.  
  4.  
  5.  

Needs:

  1.  
  2.  
  3.  
  4.  
  5.  

Weekly Goals:

  1.  
  2.  
  3.  

Specific Problem Areas/Questions:

The above has been discussed between student and supervisor.

Student's Signature:____________________________

Supervisor's Signature:_________________________