Action Plan Template
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1Local Agency Name: ___________________________
Goal (Local Agency Specific):
_________________________________________________________________________________
%
Date
Data Source
Local Agency Goal
Baseline:
Progress:
Progress:
Local Agency Final:
STRATEGY:
ACTION STEPS: (what & why)
WHO:
WHEN:
SPECIAL NOTES:
1.
2.
3.
4.
5.
6.
7.
Evaluation:
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