MADISON COUNTY SCHOOLS



SCOTTSBORO CITY SCHOOLS

SPECIAL EDUCATION SERVICES

PARENT/GUARDIAN TRANSITION QUESTIONNAIRE

Student Name _______________________________DOB ____________Date ____________

School __________________________________________________Grade_______________

Home Address ________________________________________________________________

Telephone Number(s)___________________________________________________________

Expected Date of Graduation _____________________________________________________

Parent(s) Name ________________________________________________________________

For the school to work with you and other agencies in getting your child ready for the World of Work, the following information would be helpful for transition planning.

Other agencies involved with student either currently or projected after graduation.

_____________________________________________________________________________

When your son/daughter made a transition in the past, such as from one school to another, what were the problems encountered, if any? _____________________________________________

_____________________________________________________________________________

VOCATIONAL NEEDS

1. When he/she graduates from school, we would like our son/daughter to participate in:

| | |

|_____ Sheltered Workshop |_____ Vocational School |

| | |

|_____ Competitive Part-time Employment |_____ 4 Years of College |

| | |

|_____ Competitive Full-time Employment |_____ Other |

2. In which kind of jobs does your son/daughter seem interested?

3. What kinds of jobs does he/she dislike?

4. Do you have preferences for occupational placement?

5. Are there jobs in which you object to your son/daughter’s placement? If so, what?

6. If there are any medical concerns which relate to your son/daughter’s vocational

placement, please state them.

7. What skills do you think need to be developed to help your son/daughter reach his/her

vocational goals?

8. In what vocational classes would you like your son/daughter to be enrolled?

PERSONAL MANAGEMENT/LIVING ARRANGEMENTS

1. What duties or responsibilities does your son/daughter presently have at home?

2. What other duties would you like your son/daughter to be able to do at home?

3. Following graduation from the public school, what you do think your son/daughter’s

living situation will be?

| | |

|_____ At home |_____ Foster home |

| | |

|_____ Apartment with support |_____ Group home |

| | |

|_____ Independent apartment |_____ Others (Specify) |

4. In which of these independent living areas do you feel your son/daughter’s needs instruction?

| | |

|_____ Clothing care |_____ Money management |

| | |

|_____ Meal preparation & nutrition |_____ Household management |

| | |

|_____ Hygiene/grooming |_____Health/first aid |

| | |

|_____Transportation |_____Consumer skills |

| | |

|_____ Parenting/child development |_____Community awareness |

| | |

|_____ Safety |_____Time management |

| | |

|_____Measurement |_____ Other |

LEISURE/RECREATIONAL NEEDS

1. What leisure/recreational activities does your son/daughter participate in when alone?

2. What leisure/recreational activities does your son/daughter participate in with your family?

3. What leisure/recreational activities does your son/daughter participate in with friends?

4. Are there any other leisure/recreational activities in which you would like to see your

son/daughter participate?

5. Are there any leisure/recreational activities in which you do not want your son/daughter

to participate?

6. What classes/activities would you like your son/daughter to participate in to develop more

leisure interests and skills?

FINANCIAL

Will your son/daughter have any of the following:

|_____earned income |_____unearned income |

|_____ insurance |_____general public assistance |

|_____food stamps |_____trust/will |

|_____supplemental security income |_____other support |

GENERAL

What would you like the school district staff to do to assist you in planning for your

son/daughter’s needs after graduation?

(O’Leary & Paulson, 1991)

02/2009

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