OUT-OF-STATE STUDENT INTERVIEW
Student Name
______________________________________
Date ________
DOB ____________
Age _____________
Facility ________________________________________________________________________________________
1. What grade are you in? __________
2. How long have you been a resident at this facility? __________
3. What does your school day look like?
4. Do you receive any related services, such as speech, OT or PT? __________
5. Do you have access to computers for your schoolwork? _________
6. Are you working towards your high school diploma or the GED?
Diploma
GED
What do you plan to do when you graduate?
How has school prepared you for your post secondary plans? (If child is 17, probe for the transfer of rights
notification.)
7. Do you participate in your IEP meetings? _________
8. Do you leave this facility for any educational purposes? Could you give me an example? ________
9. What do you do in the summer?
10. What are 3 things you like about this school?
1.
2.
3.
11. What are 3 things you do not like about this school?
1.
2.
3.
12. How often do you see your caseworker? ________
Comments:
West Virginia Department of Education
October 2011