JOB PREFERENCE INVENTORY

Name:NO:

COPYRIGHT. 1996 C.W. ROBINSON AND R.S. MCALLISTER. ALL RIGHTS RESERVED

VOCATIONALLY RELEVANT BEHAVIORS

D01 Towns or Areas in which the person chooses to work are:

List locations or zip codes in which the person chooses to work.

If person has no preferences for work location, enter “NONE”.

Comment:

D02 Transportation options available to this person are:

  1. Walk.
  2. Bicycle.
  3. Significant other.(e.g. Family member, Personal Care Attendant)
  4. Co-worker.
  5. Public Transportation.
  6. A combination of transportation options.

If you select option 6, please explain.

Comment:

D03 The amount of work acceptable to this person will be:

  1. Part time.
  2. Variable hours.
  3. On call.
  4. Full time.

If you select options 2 or 3, please indicate limits.

Comment:

D04 Work shifts acceptable to this person will be:

  1. Daytime only.
  2. 2nd Shift only.
  3. 3rd Shift only.
  4. Regularly Rotating Shift.

If you select option 4, please explain.

Comment:

D05 List previous work experience:

Include places, dates, duties, titles, etc.

If no previous work experience, type “NONE”.

JOB PREFERENCE INVENTORY

Name:NO:

COPYRIGHT. 1996 C.W. ROBINSON AND R.S. MCALLISTER. ALL RIGHTS RESERVED

Comment:

ENVIRONMENTAL CHARACTERISTICS

D06 This person chooses to have other workers:

  1. In close proximity.
  2. Not in close proximity.
  3. In some other arrangement.

If you select option 3, please explain.

Comment:

D07 This person chooses to work with:

  1. Large numbers of other people.
  2. Small numbers of other people.
  3. Some combination of group size.

If you select option 3, please explain.

Comment:

D08 This person chooses a working layout which is:

  1. Wide open.
  2. Secluded.
  3. Some combination of working layouts.

If you select option 3, please explain.

Comment:

D09 This person chooses a work area which is:

  1. Subject to heavy traffic.
  2. Subject to light traffic.
  3. Some combination of traffic patterns.

If you select option 3, please explain.

Comment:

D10 This person chooses to work:

  1. Indoors.
  2. Outdoors.
  3. Some combination of indoor and outdoor work.

If you select option 3, please explain.

Comment:

JOB PREFERENCE INVENTORY

Name:NO:

COPYRIGHT. 1996 C.W. ROBINSON AND R.S. MCALLISTER. ALL RIGHTS RESERVED

Comment:

D11 This person chooses working conditions which are:

  1. Hot.
  2. Hot with variations.
  3. Cold.
  4. Cold with variations.
  5. Warm stable.
  6. Cool stable.
  7. Another pattern of temperature & stability. (Please explain.)

Comment:

D12 This person chooses working conditions which are:

  1. Subject to the Elements.
  2. Protected from the Elements.
  3. A combination of contact with the elements.

If you select option 3, please explain.

Comment:

D13 This person will accept working conditions which are:

  1. Loud.
  2. Quiet.
  3. A combination of loud and quiet conditions.

If you select option 3, please explain.

Comment:

D14 Working conditions which include FUMES are acceptable:

Y = Yes.

N = No.

Comment:

D15 Working conditions which include ODORS are acceptable:

Y = Yes.

N = No.

Comment:

JOB PREFERENCE INVENTORY

Name:NO:

COPYRIGHT. 1996 C.W. ROBINSON AND R.S. MCALLISTER. ALL RIGHTS RESERVED

D16 Working conditions which include DUSTS are acceptable:

Y = Yes.

N = No.

Comment:

D17 Working conditions which include MISTS are acceptable:

Y = Yes.

N = No.

Comment:

D18 Working conditions which include GASES are acceptable:

Y = Yes.

N = No.

Comment:

TASK CHARACTERISTICS

D19 Regarding SCOPE & VARIETY, this person chooses work:

  1. Which is varied.
  2. Which is repetitious.
  3. Some combination of varied and repetitious.

If you select option 3, please explain.

Comment:

D20 This person chooses work which is:

  1. Complex.
  2. Basic.
  3. Some combination of complex and basic work.

If you select option 3, please explain.

Comment:

D21 This person chooses work which is physically:

  1. Strenuous.
  2. Sedentary.
  3. A combination of strenuous & sedentary work.

If you select option 3, please explain.

Comment:

JOB PREFERENCE INVENTORY

Name:NO:

COPYRIGHT. 1996 C.W. ROBINSON AND R.S. MCALLISTER. ALL RIGHTS RESERVED

D22 This person chooses work, which primarily requires:

  1. Fine motor skills.
  2. Gross motor skills.
  3. A combination of fine & gross motor skills.

If you select option 3, please explain.

Comment:

D23 This person chooses work which involves lifting:

  1. Objects weighing less than 10 lbs.
  2. Objects weighing less than 20 lbs.
  3. Objects weighing more than 20 lbs.
  4. Some combination of lifting.

If you select option 4, please explain.

Comment:

D24 This person chooses work which requires mostly:

  1. Sitting.
  2. Standing.
  3. Walking.
  4. Some combination of work position.

If you select option 4, please explain.

Comment:

D25 This person chooses work where the production rate:

  1. Is very significant.
  2. Is moderately significant.
  3. Is minimally significant.
  4. Varies.

If you select option 4, please explain.

Comment:

D26 This person chooses work where discriminations are:

  1. Gross in nature.
  2. Detailed in nature.
  3. Some combination of discrimination types.

If you select option 3, please explain.

Comment:

JOB PREFERENCE INVENTORY

Name:NO:

COPYRIGHT. 1996 C.W. ROBINSON AND R.S. MCALLISTER. ALL RIGHTS RESERVED

OTHER INFORMATION

D27 Successful instructional techniques have included:

Comment if possible. Otherwise type “NONE”

Comment:

D28 What level of employer support will be needed?

Comment if possible. Otherwise type “NONE”

Comment:

D29 List jobs similar to this person’s characteristics:

Comment if possible. Otherwise type “NONE”

Comment:

D30 Other comments or considerations:

Comment if possible. Otherwise type “NONE”

Comment: