Weekly Report Checklist
Please take a few minutes each day or two to complete this checklist, indicating which activities you did, on which days, and for how long. This report will help you self-monitor and help us collect some of the data we need. You will submit this report to your liaison.

E.g.
ACTIVITY M TU W TH F
Interviewed student on goals   20 min. 15 min.    
Worked on setting short-term goal 15 min.   15 min.    
Explained self-consequating       20 min.  

Activity Checklist