Student Interview for Transition Planning
Italics indicate the corresponding area on the IEP (Forms B & F)
Name:Date:
School:______
Interests, Preferences and Strengths:
Post Secondary Living
I plan to move away from home when I am (age).
I plan to live in: a large city, a small town, country (rural area)
If you have a particular place in mind, list it here:
Places I will go in my community:
banks movie theaters public library
restaurants work shopping malls
friends’ houses video rental store church
grocery store parks/recreational spots golf courses
discount stores community centers vote
night spots employment agency other
When I live on my own, I plan to live in:
An apartment A condominiumDormitory
A mobile home A house_____Other______
I want to live:
_____ Alone With my husband/wife
_____ With parents With one or more roommate(s)
______With someone to assist me
To reach this goal, I will need to:
These are the skills which I currently demonstrate at home:
_____ Cleaning Cooking_____ Grocery shopping
_____ Laundry Checking account_____Scheduling of
_____ Debit card_____ Savings account appointments
Budgeting Clothes shopping Taking medications
Home repairs Paying bills_____ Cell phone
_____ Computer use_____ Video games
Other______
When I live on my own, I plan to get around by:
Driving my own car Riding my bike Walking
Riding a motorcycle Riding with a relative Other
Riding public transportation Riding with friends
I currently have a _____Driver’s Permit _____Driver’s License _____Neither
To reach this goal, I will need to:
Post Secondary Learning
Right after high school, I plan to:
Go right to work full-time_____ Receive “on-the-job” training
Work part-time_____ Learn a “hands-on” trade
Attend a technical/trade school Join the military
Attend a 2-year college* Attend a 4-year college/university*
*The schools I am most interested in attending are
To reach this goal, I will need to:
Post Secondary Working
I have earned money with the following part-time jobs (mowing lawns, babysitting, farm work etc):
______
These are the work / employability skills that I have learned:
I am interested in these job areas:
After I have completed my education (high school and post-high school), the career I would like to have is:
To reach this goal, I will need to:
Employability Skills (Working Results)
Please indicate your use of these skills: 1 = Rarely, 2 = Sometimes, 3 = Always
_____Punctuality _____ Attendance _____Accountability _____Follow directions
_____Stay on task _____Complete tasks _____Accept constructive criticism _____Work independently _____Work as part of a team
To improve my job skills and and increase opportunities for employment, I will:
Attend college:_____ 2 year_____ 4 year
Become an apprentice _____Look for a job coach _____
Seek employment that offers on-the-job training _____
Enroll in workshops at a Community College _____
Course of Study
To be prepared to live and work on my own in the future, it would be beneficial for me to take the following classes and be involved in these activities: (Also Form F)
Which of these Adult Service Providers will you use?
_____ Vocational Rehabilitation_____ WIA (Workforce Investment Act)
_____ HCBS Case Management_____ TAP (Transition Alliance Program)
Recreation and Leisure
After I graduate from high school, these are the things that I will do in my
free time:
bowling dining out golfing
dating camping traveling
volunteering fishing hunting
partying skiing dancing
watching TV reading cooking
sewing crafts woodworking
swimming hiking talking on phone
sporting events visiting friends taking community
education classes
going to movies renting videos exercising regularly
_____ driving around playing sports joining a health
club
_____ listening to music______Playing video games _____ Use computer
_____ skateboarding______horseback riding
other other______
To reach these goals, I will need to (get my driver’s license, earn spending money, take craft instruction, etc):
______