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Monthly Activity Summary: Youth 18-21
Summaries are due on the 2nd of each month
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
2016
2017
2018
Community Advisor
Young Adult
Identified Goals
Goal #1
Goal #2
Goal #3
Date
Duration
Goal
Contact Description
Comments/Positive Experiences
Challenges/Concerns
Provide any updates to the following information:
Residence of Child
Child's Home Phone Number
Child's Work Phone Number
Child's Cell Phone Number