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Example: Completed action plan form

Goal Setting




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.