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Individual Learning Plan

Student Name: Sam Pull Student Phone Number: 216-123-4567

Emergency Contact Name: Sam Spouse Phone Number: 216-765-4321

Washington 13 Score: 4 Primary Goal: Get my GED

Secondary Goal (optional): Pass Civil Service Exam

Assessment Scores:
Date Test Name Form &Level Subject Scale Score/Ach Grade Equivalent
8/4/2009 TABE 9M Reading 520 5.6
9D Math Computation 514 5.2
Applied Math 580 7
Total Math 554 6.2

Short Term Goals & Activities

Date Set: 8/4/2009 Goal: Pass Civil Service Exam Date Met:
Activity Date Completed Assessment Score
NY State Civil Service Online Test Guide
NY State Civil Service Test Guide: Practice Test
Civil Service Test Guide from Public Library
Apply to Take Civil Service Exam

This form brought to you by the Sandra Sullivan Learning for Life Program.