Developmental Counseling Report

DEVELOPMENTAL COUNSELING REPORT

Cadet Name (Last, First): ______CO: ______CWID: ______Home Town (City, State): ______Roommate: ______

ACADEMIC PILLAR  Address proficiency, path to graduation, career plan, and resources needed to improve

Last semester GPA:______Cumulative GPA:______Academic Class: ______Major: ______Biggest academic challenge:______Plan to address:______Academic goal:______Plan to achieve:______Notes:

MILITARY PILLAR  Address conduct, duty, chain of command position, and leadership

Current Duty Position: ______Previous Duty Positions: ______Club membership and leadership positions:______Past and current conduct issues: ______Principled leadership behavior you want to focus on:______Plan to achieve:______ROTC :______Contract?:______If yes, ROTC chain of command position:______Notes:

CHARACTER PILLAR  Address spirit of the Honor Code, respect, and ethical decision-making

Most serious current ethical dilemma:______Plan to resolve:______Notes:

FITNESS PILLAR  Address resiliency, diet, sleep, stress, emotional and spiritual well-being, and healthy lifestyle issues Previous CPFT Score:______Pass Fail Current CPFT Score:______Pass Fail HT:______WT:______Pass Fail Body Fat (if applicable)______Pass Fail Physical Pillar Goal:______Plan to achieve:______Corps/Club Squad:______Intramurals:______Notes:

CC Form 112 (JULY 2017) Overall Cadet SELF-ASSESSMENT TO BE COMPLETED BY THE CADET BEING COUNSELED: Describe your strengths, weaknesses, goals, and plan to improve/sustain below

Strength # 1______Plan to Sustain______

Strength # 2______Plan to Sustain______

Weakness # 1______Plan to Improve ______

Weakness # 2______Plan to Improve ______

Near term (≤ 1 year) goal and plan to achieve:______Mid-term (2-4 years) goal and plan to achieve:______Long term (≥ 5 years) goal and plan to achieve:______

Overall TAC Assessment of Cadet Note cadet’s overall performance, potential, strengths, weaknesses, and expectations below

Date:______Cadet Signature:______TAC Signature:______

CC Form 112 (JULY 2017)