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2022-2023 Parent Form: Parent Transition Survey (only complete if your child is 13+)
Student Name
*
Answer Required
Following graduation, I would like my child to pursue futher education/training.
*
Answer Required
Yes
No
If yes, please indicate the type(s) of post-secondary education/training that will benefit your child.
Answer Required
on the job training in the community at employer site
with support of a job coach
vocational training program in a supervised facility
with other peers with disabilities such as in a workshop
training program in supervised facility
focus on daily living skills instruction and practice
Following graduation, I would like my child to pursue employment.
*
Answer Required
Yes
No
If yes, please indicate the type(s) of employment you believe will benefit your child.
Answer Required
employment within a small supervised group in the community such as a cleaning crew
employment with other peers with disabilities in a supervised facility such as an assembly line workshop
individualized employment in a supervised facility such as shredding paper a few hours a week
Other:
Describe your child's interests and abilities related to future education/training and employment opportunities.
*
Answer Required
List post-secondary programs sites that you have visited or have an interest in visiting.
*
Answer Required
Describe characteristics you are seeking in your child's future education/training and employment program.
*
Answer Required
List medical concerns related to your child's future education/training and employment.
*
Answer Required
Following graduation, where do you anticipate your child will reside?
*
Answer Required
in a minimally supervised residence with some assistance/roommates
in a 24-hour supervised residence with maximum assistance
at home with parents/guardians/family
Other:
List responsibilities/chores your child completes at home presently.
*
Answer Required
List daily living skills you would like your child to learn or improve.
*
Answer Required
Following graduation, which type(s) of transportation do you anticipate your child will use?
*
Answer Required
walk or ride a bike independently
use public transportation independently
transportation provided by family
Other:
Does your child have any of the following or applied for any of the following?
*
Answer Required
photo ID card (age 16)
registered to vote (age 18)
discounted bus fare card
registered for selective service (mandatory for males age 18)
None
Are you or your child involved with any of the following agencies?
*
Answer Required
OVR
Beaver County Behavioral Health
Achieva
Other
None
If your child is involved with an Supports Coordinator agency (e.g., BCBH, Staunton Clinic, etc.), then please enter the agency name and the name of his/her caseworker. Enter "n/a" if your child does not yet have a Supports Coordinator.
*
Answer Required
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