The purpose of this form is to help you plan to transfer what you've learning today to your everyday life. Be realistic - so that the things you plan to do here can be completed and help you succeed.

1. When I get back from this session, I'll discuss what I've learned and my overall impressions of today's program with:
   
   
   
   Person: _________________________ Place:_________________________ Time:________
   
   
   
   What I think I'd most like to discuss is:
   
   
   Why I want to discuss this:
   
   
   
   
2. I'm going to "stretch" my knowledge about this topic by finding the following book, article, tape, or person:
   
   
   
   
3. I'm going to try to implement part of what I learned today by:
   
   
   I'm going to discuss the results of this experience with:
   
   
   
   
4. Other activities I'd like to do to make sure that my learning in this top/area continues beyond this event and the next session:
   
   
   
   If you need prodding, consider signing a copy of this worksheet and sending it to another person who will serve as adviser/coach/prodder.
   
   
   Signed ________________________________________________________
   
   Address______________________________City________________________
   
   State_____________________ Zip__________________________
   
   
   
   
   
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