Student Transition Planning Survey
Student: ______
Grade: ______
Date Completed:______
Student Transition Survey
Name: ______ Date: ______
DOB: ______Grade: ______Age:______Graduation Year: ______
Learning Support Teacher: ______
SCHOOL
1. What is your favorite subject in school? ______
Why? ______
2. What is your least favorite subject in school? ______
Why? ____________
3. What is your easiest subject in school? ______
4. What is your most difficult subject in school? ______
5. What electives have you taken?
a. ______liked/disliked
b. ______liked/disliked
c. ______liked/disliked
d. ______liked/disliked
e. ______liked/disliked
f. ______liked/disliked
6. What other electives would like to take while still in high school?
a. ______
b. ______
c. ______
d. ______
7. In what school clubs, sports, or activities do you participate?
a. ______
b. ______
c. ______
d. ______
8. Are you interested in a visit to the local career and technical center? YES NO
9. If your answer to # 8 is YES, in which program are you interested?
______
WORK EXPERIENCE
10. Have you had any paid work experience? YES NO
11. If your answer to #10 is YES, please list your paid work experiences below.
a. ______
b. ______
c. ______
d. ______
12. Have you had any volunteer work experience or done any community service?
YES NO
13. If your answer to #12 is YES, please list your volunteer work/community
service experiences below.
a. ______
b. ______
c. ______
d. ______
14. What is your work preference? Please circle.
Physical Work Desk Work
Inside Work Outside Work
Working Alone Working with Others
Repetitive Tasks Varied Tasks
POST-SCHOOL PLANS
15. What are your plans after graduating from high school?
______Post-secondary Education/Training
______Competitive Employment
______Military
______Unsure
POST-SECONDARY EDUCATION / TRAINING
16. What type of post-secondary school would you like to attend?
_____LifeLink PSU______Community College ______Four-Year School ______Technical School ______Union apprenticeship ______Trade School ______Other (please name)
______On-the-job Training (go to QUESTION #21) ______
17. What career area would like to study? ______
18. Do you think that you will need supportive services while attending a post-secondary school? YES NO
19. Where do you plan to live while attending a post-secondary school?
_____ At school (dormitory, apartment, etc.)
_____ With family or friends
_____ Other: (be specific) ______
20. Do you plan to work while attending post-secondary school? YES NO
______Full time ______Part-time
(Go to QUESTION #26)
EMPLOYMENT
21. What career area do you plan to pursue after graduating from high school? ______
22. Do you plan to work part-time or full-time? ______
23. When employed, what will our living arrangements be?
____ With family ____ With friends ____ Independently ____ Other (explain) ______
24. Do you plan to join the military after graduating from high school? YES NO
25. If your answer to question #28 is YES, what branch of the military are you interested enlisting in? ______
RECREATION/LEISURE
26. What leisure activities (free time) do you enjoy? ______
______
27. Do you take any classes outside of school (music, dance, etc.)? YES NO
If your answer is YES, list the classes. ______
______
28. Are you involved in any community activities? YES NO
If your answer is YES, please list the activities. ______
______
TRANSPORTATION
29. What type of transportation will you use to go to and from school and/or work?
____ Drive yourself ____ Public Transportation _____ Parent/friend/carpool
____ Other (explain) ______
30. Do you have your Learner’s Permit or Driver’s License? YES NO
If YES write the one that you have. ______
31. Do you plan to use public transportation after high school graduation?
YES NO
If your answer to question #32 is NO, what other form of transportation is available to you? ______
SELF – ADVOCACY
32. What goal would you like to accomplish in the next year? ______
______
33. What goal would you like to accomplish one year after completing high school?
______
34. What goal would you like to accomplish five years after completing high school? ______
______
35. Do you know what an IEP is? YES NO
36. Can you explain why you have an IEP? YES NO
Explain: ______
______
______
37. Have you attended your IEP meetings? YES NO
38. Do you feel that you have been an active part of your IEP team? YES NO
39. What do you think is your greatest strength?
______
40. What do you think is a skill that you need to improve? ______
41. What do you feel that you need to help you be successful after graduation from high school? ______
______