YCAN Goals Worksheet
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What County Do You Live In?
*
Park County, Wyoming
Hot Springs County, Wyoming
Teton County, Wyoming
Today's Date
*
-
Month
-
Day
Year
Date
SPECIFIC: What exactly will you accomplish?
*
MEASURABLE: How will you know that you have accomplished your goal?
*
ACHIEVABLE: Is your goal realistic with sufficient effort and commitment? Do you have the resources required? If not, how will you get them?
*
RELEVANT: Why is this goal important to you?
*
Timely: When will you achieve this goal?
*
The benefits of this goal will be...
*
List the potential obstacles and potential solutions
*
Who are the people who can help you?
*
List the steps you will take to accomplish your goal and the date you wish to accomplish them
*
Signature
*
Submit
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