College Authorization Case Note Template

Purpose (specific purpose for meeting)

Assessment:

• Current situation

  • College attending (current release?):

  • Class schedule/number of credits (if under 12, was an exception done?):

  • Book list:

  • College terms and conditions:

  • Living situation:

  • FAFSA information:

  • Cumulative GPA (delete if first year):

  • Previous semester successes/challenges:

• Tuition:

• Room/board:

• Books:

• Grants and scholarships:

• 5% client contribution:

Intervention:

• Guidance and counseling provided by:

• Job readiness training provided by (if not pre-ets):

• Pre-employment transition services (list service) provided by:

• Additional services provided (delete if no other service provided)

Plan: (amount to be authorized and not exceed, dates the authorization is effective, set up progress meeting)

• Next meeting scheduled for (if pre-ets -no more than one month out):

Counselor next steps:

Client next steps: