One on One Assessment Application Form

Offered to our Apprentice students for an annual assessment session. Please complete this form:

Name of Student *
Date of Birth *
Student's Age
SHORT TERM GOALS (3 – 6 MONTHS):
LONG TERM GOALS (1 YEAR):
What inspires you to attain your goals?
What resources do you need to do to attain your goals?
Do you have these resources?
What alternatives / resolution stop you from obtaining the resources you need to attain your goals?
What other impediments do you think hinder you from attaining your goals?
What can RKP do to assist you other than providing a platform for your goals?
Other comments:
Student Photo
Today's Date
Available Dates for Meeting *Enter 3 dates or day and time when you are available for the meeting. The meeting is approx. 30 minutes. Please choose days and times that do not coincide with any apprentice session or class that your teacher is schedule to teach.
Name of the coach you request for your meeting
Phone number where we can text or call you
Email

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