Name:___________________________________________________________________________

 

Week Ending:__________________________________________________________________________

 

 

LONG TERM GOAL (within the next five - ten years) ________________________________________________________________________________

 

________________________________________________________________________________

 

________________________________________________________________________________

 

 

 

 

SHORT TERM GOAL / VOLUNTEER WORK (within the next three months)

 

I Will Complete # of Hours to help reach my long-term goal.

 

 

PLAN

 

In the past the following has gotten in the way of me reaching my goal:

 

________________________________________________________________________________

 

________________________________________________________________________________

 

________________________________________________________________________________

 

So for the next two weeks I will do the following instead:

 

________________________________________________________________________________

 

________________________________________________________________________________

 

________________________________________________________________________________

 

 

SUPPORT

 

The following people will support me to reach this goal:

 

1.  ________________________________________  Relationship To Me ________________

 

2.  ________________________________________  Relationship To Me ________________

 

 

3.  ________________________________________  Relationship To Me ________________

 

 

Your Signature_____________________________________________________Date____________