Harry S Truman High School s1

Harry S Truman High School Student Transition Questionnaire Learning Support – Student Survey

General Student Information Name______Date of Birth______Grade______

Father’s Name______Mother’s Name______

I. Questions about How You Learn:

Why do you have an IEP? ______

What assistance do you need in school to help you learn? (Accommodations?)______

What is your biggest concern about school?______

II. Educational Goals: In what type of job/occupations do you see yourself working in five years after graduation from high school? ______

What do you want to study or train to be?______

What courses do you need to take this year in high school that will help you attain your employment and career goals?______

Upon graduation, I want to go on for future education/training:

______YES ______NO ______Undecided

If yes, please check each kind of post-secondary education or training that is of interest:

______4 year college ______Community College ______Technical/Trade School

______Military ______Not sure what training is needed for career of interest

III. Post Secondary Employment

1. What work do you plan to do when you graduate?______

______

2. What kind of jobs can you do? ______

______

3. Are there jobs that you do not like to do? If so, what are they?

______

4. Do you have work experience? ______If yes please list experience:______

______IV. Community Living after Graduation (Please check one from the list)

____ Live independently in an apartment or home

____ With family member (who?) ______

____ With support

____ Supervised apartment (which one?) ______Group home (which one?) ______

____ Other, please describe ______Check all that you know how to use: ____ hospital ____ post office ____ shopping malls

____ grocery store _____ bank _____ public transportation

V. Recreational and Leisure Options

A. Leisure Interest Inventory : Check all of the following activities you enjoy:

_____ swimming _____ lifting weights _____ skiing

_____ fishing _____ camping ______listening to music

_____ walking _____ bowling ____ watching TV

____ movies ____ ball games ____ caring for pets

____ Special Olympics _____ computer use

_____ other ______

VI. Transportation Options

How will you get around the community and to work? Please check each one that you will use.

Drive ______use bus transportation ______take a taxi ______ride a bicycle ______walk ______depend on other family members ______

other ______

Do you need training on how to use SEPTA ?______

VII. Agency Involvement – Which agencies are you currently involved with? ______

______

What is your biggest concern for your future?

______

Is there anything else we need to know about you to help you plan your future?

Thank you for helping us plan your future with you!!!