CAS ACTIVITIES PROPOSAL FORM

This form must be completed for each activity you hope to undertake.
Name______________________________________________
Name of Activity_______________________________________________
Please circle category/ies of activity C A S
Name of Place or Organization__________________________________________
Address____________________________________________________________________
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Contact person/ supervisor(s)________________________________________________
Phone number for supervisor________________________________________________
Estimated number of hours__________________________________________________
Date of commencement of activity____________________________________________
Signature of supervisor _______________________________________ date __________

Signature of CAS coordinator ________________________________ date __________

Personal checklist does this meet the CAS criteria?

Real, purposeful activities, with significant results.

Personal challenge.
Thoughtful consideration, such as planning, reviewing progress, reporting.
Reflection on results and personal learning.

Describe the
activity_____________________________________________________________________
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To which areas of CAS does it belong and how does it meet CAS criteria?
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What do you hope to accomplish, what are your goals?
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What skills will you need to succeed?
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How will this challenge you and push you further?

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How will you measure success in this project/activity?
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Further comments:
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CAS LOG (to be completed on a weekly basis)

STUDENT NAME___________________________

Activity

Category

Date

Time Spent

Supervisor
signature

CAS ACTIVITY REFLECTION FORM

Name______________________________________________________
Date____________________
Activity/Project Name___________________________________________
Activity Completion Date ______________________________________
Describe the activity.

What were the aims of this activity? Did you meet them? why/why not?

What skills did you learn or develop?

On a scale of 0 10, how would you rate yourself in these skills?

What did you learn about yourself?

Have any of your views or attitudes changed?

How did this activity benefit other people or institutions?

What would you change if you did this activity again?

What would you like to do next if you were to continue with this activity?

To be completed by the Adult Supervisor

Name__________________________________________________
Organisation/activity___________________________________
Did the student discuss their aims and targets with you?

Did the student meet your expectations concerning punctuality, responsibility, initiative,
planning, organization and commitment?

Where relevant, please describe, briefly, how the student was of value to you and your
organization.

Additional comments:

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Adult supervisor signature

Date

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CAS Coordinator/Adviser signature

Date