Sample Forms

This module will review follow-up materials to highlight how literacy can make a difference in people’s lives, encouraging learners to participate in life-long learning opportunities.

Follow-Up Sample Forms

Download sample forms below from the Follow-Up module.


Sample 1: John Howard Society of Kawartha Lakes and Haliburton

Outreach Literacy Program


Sample 2: Northern Connections Adult Learning Centre

Learner File Checklist (page 1 & 2)


Sample 3: North Bay Literacy Council

Pre-assessment Information Gathering Form


Sample 4: CABS Literacy

Quick Screen

Source: Common Assessment of Basic Skills by Judith Fox Lee & Rose Strohmaier (Third Edition); Literacy Link Eastern Ontario. Used with permission. Also visit CABS Online. (http://www.lleo.ca/col/cabs_online.html)


Sample 5: Gateway Centre for Learning

Adult LBS Program - Additional Intake Information (1 & 2)


Sample 6: ALSO (Alternative Learning Styles and Outlooks)

Ongoing Assessment Tracking Form


Sample 7: Literacy Council York-Simcoe

Further Education Goal Path Assessment Tracking Form


Next in the Module > Acknowledgements

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