Example: Completed action plan form
Goal Setting
1/4/2013
Initiative:
Date:
Action step or change to be accomplished:
To get an A in Algebra
What actions or changes will occur:
Parents and guardians who contribute (by helping with homework, and creating good study environment); will study more and dedicate more hours to algebra; will take fewer breaks and watch less TV in order to study more.
Who will carry it out:
Me (the protégé) with the help of my mentor and parents.
By when (for how long):
Start as soon as possible and carry it out until algebra grades substantially improve.
What resources are needed:
Books, school material, time, and recognition from parents and mentor. Celebration after accomplishments.
Communication (who should know what):
Parents and mentor must be aware of the developments and status of this action plan so that they can provide support and recognition.