OHVA Parent Survey

Parent Name:_Christina o Bubble one circle for grade level!

Swain____________
o 9th Grade Level:
Student Name:___Tianna
Swain________________  10th

Date:______09/13/2010_____________ o 11th
____
o 12th

o 12th Plus Age (19) (20) (21)

Please take a moment to help us, help you plan your child’s future!

What job will you do to support yourself after high school? (Section 1 Future Planning)

□ Hospitality/tourism □ Marketing
□ Information Technology (computers) □ Finance
□ Construction work/heavy equipment □ Arts/drama/communication
□ Manufacturing/factory work □ Agricultural/environment
□ Animal care/science
□ Education/training (teacher/human resource)
□ Engineering/Science Technology □ Child Care Worker

□ Health Science (Doctor, Nurse, Nurse Aide)  Hair Stylist

□ Government/Public Administration □ Physical, Occupational/ or Speech Therapist

□ Law Enforcement/Fire Fighter/Paramedic □ Sports

□ Business/Administrative Services (Secretary, □ _________________________________

office worker)
Where are you going to live after high school? After High School, What do you plan on doing for
(Section 1 Future Planning) leisure or fun?
□ At home, with parents/relative □ Use a computer, reading
□ College Campus  Hobbies (What
□ Spouse Kind)_Art,music______________________

 Other_Try to get my own place__________

□ Sports (What type)________________________

__________________ □ Attend Church

How to plan to get places?
 Purchase your own car
□ Bus, public transportation
□ If 15, check (√) if you have your temporary
license.
□ If you have a temporary license, are you
planning on getting permanent Driver’s
License
What are you going to do to continue to
learn?
□ (Circle one) 2 year college or 4 year college
 Career/technical school
□ Doing outdoor activities_________________
What is your course of study for high school?
(Circle one)
a. On the job training and a job in the
community?
b. College Prep to attend college?
 Career technical, taking career classes at a
vocational school?
c. Functional living skills? (filled out by parent or
 □ Military (what Branch) Army, Navy, Air Force guardian)Unique Curriculum
Marines
□ Full time or Part time Work (Circle One) d. Ohio high school core (8th grade)
□ DD Services (Sheltered Work)
□ Community vocational classes

If your child is turning 18 have you:

Has your child registered with the Selective

Service?
⃝ yes ⃝ No

Are you going to register to vote?

⃝ Yes ⃝ no

Will your student sign legal papers when they

turn 18? Age of Majority

⃝ Yes No ⃝

If 15, are you going to apply for a work

permit?

Yes ⃝ No ⃝

What are your strengths and skills? (For

example are you organized?) (Type Here)

⃝ Following directions

⃝ Good Listener

⃝ I can do schoolwork on my own

⃝ I organize my school materials

⃝ I put things away when I am finished

⃝ I can keep a calendar

⃝ Good study skills

⃝ I work well with others or in groups

⃝ I work better alone

What skills in high school are challenging that we can help you prepare for living on your
own? (For Example, I am unorganized, cannot keep a calendar, cannot complete
assignments on time, type below)

⃝ Following directions is difficult for me

⃝ Listening to others

⃝ I need help when I do my schoolwork

⃝ I am not organized

⃝ I have trouble finding school materials on my desk

⃝ I cannot keep a calendar or agenda

⃝ I lack study skills

⃝ Working in groups distracts me

Any other Information you would like to

add:___________________________________________________________________________

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Created By Jennifer Speed