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Oregon Youth Challenge Program Post Residential Report Form
Case Manager
Reporter Name
Your answer
Reporter Type
Reporter Email
Your answer
Cadet Name
Your answer
Cadet Email
Your answer
Class Number
Reporting Month
4 Contacts or 4 Hours
During the reporting period, did you have a minimum of 4 contacts, four hours of contact, or a combination of both?
Contact 1 Type
Contact 1 Date
MM
/
DD
/
YYYY
Contact 2 Type
Contact 2 Date
MM
/
DD
/
YYYY
Contact 3 Type
Contact 3 Date
MM
/
DD
/
YYYY
Contact 4 Type
Contact 4 Date
MM
/
DD
/
YYYY
Does the cadet have a placement?
Placements are School, Employment, Military, Miscellaneous/Volunteer.
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