CALIFORNIA CADET CORPS
DEVELOPMENTAL COUNSELING FORM
DATA REQUIRED BY THE PRIVACY ACT OF 1974
To assist leaders in conducting and recording counseling data pertaining to subordinates.
For subordinate leader development. Leaders should use this form as necessary.
Disclosure is voluntary.
Name (Last, First, MI)
PART I - ADMINISTRATIVE DATA
Date of Counseling
Time of Counseling
Name and Title of Counselor
PART II - BACKGROUND INFORMATION
Purpose of Counseling: (Leader states the reason for the counseling, e.g., performance/professional growth or event-oriented counseling,
and includes the leader's facts and observations prior to the counseling.
PART III - SUMMARY OF COUNSELING
Complete this section during or immediately subsequent to counseling.
Key Points of Discussion:
Note: Both the counselor and the individual counseled should retain a record of the counseling.
CACC FORM 24, June 2013
Plan of Action: (Out