G D GOENKA WORLD SCHOOLCAS: Activity/ Project Proposal form

Please complete, print, and return to Mr. Gyanendra Tewatia BEFORE beginning any CAS

project/activities. All projects/activities are subject to approval, and any project

started before approval may not be counted.

Name: ________________________________ Date: ___________

I would like to propose the following activity:

____________________________________________________

This fits into the category of (creativity) (Action) (Service)

Describe the activity:

 List the goals related to the activity:

 

Learning outcomes going to achieve:

I expect to complete approximately ___hours in this activity from _______ to _______ (dates).

The sponsoring adult who will document my activity is

Mr./Mrs.____________________________________

His/her business phone number is ___________

I would produce authentic evidence for my project/activity in the following form: Photos/ videos, Certificate, Copy of program schedule/

Fixture of the Matches, Letter of Certification from consent authority/District Sports Officer (DSO), any other documentary evidence.

Student Signature Adult Supervisor Sign CAS

Mentor Sign

…………………………………………………………………………………………………………………………

To be completed by CAS Coordinator

This activity is approved: [ ]

This activity is not approved until the following changes are made: [ ]

Gyanendra Tewatia; IBDP CAS Coordinator 2011-13 09958628767

Signature of CAS Coordinator Date:

Note: It is the student’s responsibility to have parent permission and an adult supervisor at all CAS endeavors that are not

school sponsored activities. G D Goenka World School does not officially sponsor any outside CAS activities and parent/students

assume their own risk for these events.

Gyanendra Tewatia; IBDP CAS Coordinator 2011-13 09958628767