Participant Name: / Date of the Assessment this IEP is based on:
Name of Host Agency/ Assignment Title: / Date of this IEP to be entered into SPARQ:
Long-Term Employment Goal(s): / Long-Term Education Goal(s):

Short-term SCSEP Goals

Goal(s) / Activities to Attain Goals / Initiation Date / Expected Completion Date / Currently Exists or Date Completed
I will prepare for SCSEP / Register with the local American Job Center (AJC) and provide the letter verifying that I have done so to SCSEP staff.
Start to plan readiness to go to work. (e.g. scheduling appointments around work time, prepare to dedicate time and energy to working and training.) / /______
Date completed
/______
Date completed
I will update my CONTACT INFORMATION / Obtain a working phone with an answering machine or voice mail.
Create a professional answering machine or voicemail message for missed calls.
Create a professional email address and if applicable update resume with same email.
Obtain and/or identify free access to a computer
Establish and/or update a minimum of one online profile (Facebook, LinkedIn,) to make sure my public image is professional (if applicable) / /______
Date completed
/______
Date completed
/______
Date completed
/______
Date completed
/______
Date complete
I will update my SUPPORT NETWORK / Create a network list of friends and business associates who I can call on for help with editing my resume, job leads, coaching, and other employment related assistance.
Develop a list of references (co-workers, supervisors, people you have supervised, vendors, customers, etc.) who I am in contact with, who know my work well enough to be able to provide me with a strong employment reference. / /______
Date completed
/______
Date completed

Additional Education Training

Please refer to the Education Basic Skills column in Section 6 of the Initial Assessment to develop short-term goals and action steps for this section.

SMART GOAL(S) / SMART ACTION STEPS TO ATTAIN GOAL(S) / INITIATION
DATE / EXPECTED COMPLETION DATE / Actual
COMPLETION DATE

Community Service Assignment

Please refer to the Job Keeping column in Section 6 of the Initial Assessment to develop short-term goals and action steps for this section.

SMART GOAL(S) / SMART ACTION STEPS TO ATTAIN GOAL(S) / INITIATION
DATE / EXPECTED COMPLETION DATE / ACTUAL
COMPLETION DATE

Job Preparation

Please refer to the Job Preparation column in section 6 of the Initial Assessment to develop short-term goals and action steps for this section.

SMART GOAL(S) / SMART ACTION STEPS TO ATTAIN GOAL(S) / INITIATION
DATE / EXPECTED COMPLETION DATE / Actual
COMPLETION DATE

Unsubsidized Employment

Please refer to the Initial Assessment to develop new action steps related to a specific unsubsidized job.

SMART GOAL(S) / SMART ACTIVITIES TO ATTAIN GOAL(S) / INITIATION
DATE / EXPECTED COMPLETION DATE / Actual COMPLETION DATE

Supportive Services

Please refer to the Supportive Services section 5 of the Initial Assessment to develop new supportive service referrals

Additional Actions To Be Taken/Initiated
Actions / Resources / Initiation Date / Completion Date
Please check any that apply:
 Received referral/service from another source;  Participant declined referral at this time;  No referral resources available
r No supportive needs at this time

Agreement

This IEP is a plan, roadmap and skill building agreement that is designed to lead you to an unsubsidized placement. By signing below, the Participant and SCSEP Project Director agree with the outlined plan and understand the level of commitment needed to achieve the proposed goals. If at any time the participant breaks this contract, (s)he may be subject to termination from the SCSCP Program.

I understand that this plan will help me in obtaining unsubsidized employment through my community service assignment and training received at ______host agency. I have assisted in the completion of my Individual Employment Plan (IEP) and I agree with the listed steps to be completed. I also understand that failure to follow through on this plan may result in disciplinary action, up to and including termination from the program.

Participant Signature______Date______

Project Director/ Staff Signature______Date______

SSAI Initial Individual Employment Plan Form Effective July 1, 2015 1