Career Launchpad Personal Career Plan

1
Name* This field is required.
First Name
Last Name
2
Preferred Name / Other Name(s) Used:
3
Social Security Number: [or other CA Gov identifier]:
4
Career Launchpad Program ID:
5
Description of Expected Activities:
Huge
Large
Normal
Small
Ok
Ok
6
Tasks / Activities
7
Activities Code
8
Projected Hours per Activity
9
Starting Date / Month
10
Ending Date / Month
11
Tasks / Activities
12
Activities Code
13
Projected Hours per Activity
14
Starting Date / Month
15
Ending Date / Month
16
Tasks / Activities
17
Activities Code
18
Projected Hours per Activity
19
Starting Date / Month
20
Ending Date / Month
21
Service Plan Goals and Objectives:
Huge
Large
Normal
Small
Ok
Ok
22
Assistance, Accommodation and Support Needs Identified:
Huge
Large
Normal
Small
Ok
Ok
23
Additional Comments:
Huge
Large
Normal
Small
Ok
Ok
24
Signed (Client Name):
25
Signed (Career Launchpad Representative):
Should be Empty:

Career Launchpad Personal Career Plan