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
Tasks / Activities Undertaken
5
Activities Code and Activities Dates
6
Hours per Activity
7
Comments:
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Large
Normal
Small
Ok
Ok
8
Tasks / Activities Undertaken
9
Activities Code and Activities Dates
10
Hours per Activity
11
Comments:
Huge
Large
Normal
Small
Ok
Ok
12
Tasks / Activities Undertaken
13
Activities Code and Activities Dates
14
Hours per Activity
15
Comments:
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Large
Normal
Small
Ok
Ok
16
Progress Assessment:
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Large
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Small
Ok
Ok
17
Challenges and Potential Impediments:
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Large
Normal
Small
Ok
Ok
18
Service Plan Goals and Objectives for the next reporting period:
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Large
Normal
Small
Ok
Ok
19
Assistance, Accommodation and Support Needs Identified:
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Large
Normal
Small
Ok
Ok
20
Signed:(Client Name)
21
Signed:(Career Launchpad Representative)
22
DOR Verifications
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Large
Normal
Small
Ok
Ok
Should be Empty:

Career Launchpad Personal Career Plan