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I-CANS Summary Form

Student Name: ____________________

Program: ______________________


Goal(s) (reasons for being in the program):



I-CANS skills in which I have gained a high level of understanding and that support the above goal(s):

Skill # Skill































Additional skills I have improved:


On the back side of this paper tell us:

1. How your have used the above skills outside of the classroom.

2. How you plan to use the above skills in the future.

3. Your future educational and /or work goals (what's next?).


Student Signature

Instructor Signature


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