Planned Academic Program Worksheet Page 2

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TERM 4:
TERM 4:
TERM 7:
TERM 7:
8. STUDENT INITIALS & DATE:
8. STUDENT INITIALS & DATE:
8. STUDENT INITIALS & DATE:
TERM 1:
TERM 1:
TERM 5:
TERM 5:
TERM 8:
TERM 8:
(Have the student initial and date beside each
(Have the student initial and date beside each
(Have the student initial and date beside each
TERM 2:
TERM 2:
term to indicate they have been counseled)
term to indicate they have been counseled)
term to indicate they have been counseled)
TERM 6:
TERM 6:
TERM 9:
TERM 9:
TERM 3:
TERM 3:
CC Form 104-R, DEC 04
CC Form 104-R, DEC 04
CC Form 104-R, DEC 04

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