G D GOENKA WORLD SCHOOL

CAS: 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: ________________________________ I would like to propose the following activity: ____________________________________________________ This fits into the category of (creativity) (Action) (Service) Describe the activity: Date: ___________

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 Mentor Sign

Adult Supervisor Sign

CAS

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

Note: It is the students responsibility to have parent permission and an adult supervisor at all CAS school sponsored activities. G D Goenka World School does not officially assume their own risk for these events.

Date:
endeavors that are not sponsor any outside CAS activities and parent/students

Gyanendra Tewatia; IBDP CAS Coordinator 2011-13 09958628767