Date: ____________________
 

Instructions:  Describe your progress in each of the following areas over the past academic year.  Also, please note how you have addressed any constructive feedback raised in your last annual review. 

Submit this report to your advisor by September 15th, and schedule an appointment with her or him by October 1st to review your report together.  After your meeting with your advisor, he or she will summarize your review in a letter to you by October 15th.
 

1. Professional Demeanor/Interpersonal Skills
 
 
 
 
 
 
 

2. Professional Development and Growth Specific to Diversity Issues
 
 
 
 
 
 
 

3. Academic Coursework (attach copy of current transcript)
 
 
 
 
 
 
 

4. Development of Practice Skills (e.g., practicum, advanced practicum, supervision, outreach).   Attach copy of evaluation form and supervisor's letter.
 
 
 
 
 
 

5. Development of Teaching and Consultation Skills.  Attach a copy of syllabus, student evaluations, other relevant documents.
 
 
 
 
 

6. Development of Research Skills (e.g., participation in research projects, apprenticeship project,  submission of conference proposals or journal articles, conference presentations, publications).   Provide on a separate sheet complete reference citation(s) in APA style for any works presented  at a professional conference or accepted by a professional journal over the past year.
 
 
 
 
 
 
 
 
 

7. Completion of Program Milestones (e.g., prelim and comprehensive exams, internship).
 
 
 
 
 
 
 
 
 

8. Summary of Strengths and Weaknesses.
 
 
 
 
 
 
 
 
 
 

9. Identify Professional Goals For the Coming Year and Areas for Future Growth.
 
 
 
 
 
 
 
 
 
 
 

Date of student-advisor review session: ___________________

Student’s signature: _________________________________

Advisor signature: ___________________________________