Transition Questionnaire

* Required

1. First Name *

2. Last Name *

3. Grade *

Mark only one oval.

9th

10th

11th

12th

4. Today's Date *

Example: January 7, 2019

Preferences

5. At school, what are your learning preferences? *

Check all that apply.

working alone
working in a group
working at your own pace
staying in the classroom to work

working in a separate/quiet location

handwriting assignments
typing assignments
Other:

6. What do you do for fun outside of school? *

Interests

7. Do you participate in a sport, club or activity at school? If so, list them below. *

8. What are your favorite classes or subjects at school? *

9. What type of job or career interests you? (you can be specific- naming the exact job or career, or broad-listing qualities of the job you want (ex. outdoors,
involving travel, working with animals, etc). *

Needs
10. What type of supports do you need in your classes? *

Check all that apply.

extra time

copies of notes
access to a quiet place to work
tasks broken down into smaller pieces

help with organization

text read aloud
typing instead of handwriting
Other:

11. What help do you need to pursue your college or career interests? (i.e. helping with a resume, interviewing, financial aid, college or career research.) *

Strengths

12. What are your best subjects in school? *

Check all that apply.

English
Math
Science

Social Studies
Art
Theater
Technology
PE
Music
Other:

13. What skills do you consider to be strengths for you at school? *

Check all that apply.

reading
writing
math
taking notes
working with my hands
working with computers
working on a team

communication
self-advocating
time-management
organization
Other:
14. What strengths do you have that will make you a good employee? *

Check all that apply.

punctual
hard working
good communication
self-advocating
ambitious
good follow through

finishing a task once started

self-stater
innovative
creative
a natural leader
Other:

College/Career Interests

15. What type of job or career do you want in the future? *

16. Do you have interest in attending college? *

Mark only one oval.

Yes

No

Maybe

17. If yes, what school are you considering attending?

18. If yes, what major are you considering studying?

19. After graduation, do you plan to have a part time or full time job? Why type of job? *

20. Do you currently have a job? *

Mark only one oval.

Yes

No

21. If yes, where do you work, what are your job duties and how many hours do you work per week?
22. What are your past jobs you have held? Where did you work, what were your job duties and how many hours did you work per week?

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