Parent Transition Survey
Student Name:________________________________________________ Date Completed:__________
Student Birth Date:__________________________________________
Anticipated Graduation Date:____________________
Name of Person Completing Survey:________________________________________________________
Relationship to student:_________________________________________________________________
In order for the school district to plan appropriately with you, your child and possibly other agencies, the
following information would be helpful for the Transition Planning for your son/daughter from school
programming to adult life:
Are there other agencies involved with the student either currently or projected after graduation?
Post Secondary Education Questions:
1. Upon graduation, what do you see your son/daughter doing for future education/training?
 4 year College
 Business School
 2-4 year College
 Training Program
 Technical School
 Community Education Program
 Other __________________________________________________________________
2. My son/daughter’s level of motivation to succeed in the academic setting is:
 High
 Medium
 Low
3. The level of control my son/daughter believes he/she has over decision making and his/her
individual success:
 High
 Medium
 Low
4. My son/daughter’s ability to identify what he/she needs had how to get it:
 High
 Medium
 Low
5. What skills do you think your son/daughter needs to develop for future academic success?
Employment Questions
1. When he/she graduates from school, we see our son/daughter participating in:
 Competitive Full Time
 Supported Employment
Employment
 Military
 Competitive Part Time
 Volunteer Work
Employment
 Other ________________________________________________
2. In which kinds of job(s) does your son/daughter seem interested?
3. What kinds of job(s) does s/he like?
4. Do you have a preference for or see your son/daughter in a particular job?
5. Are there jobs in which you object to your son/daughter’s participation?
6. Are there any medical concerns relating to your son/daughter’s job choice?
7. What skills do you think need to be developed to help your son/daughter reach his/her
employment goals?
8. In what kind of classes would you like your son/daughter to be enrolled?
Independent Living Questions:
1. What chores or responsibilities does your son/daughter presently have at home?
2. What other responsibilities would you like your son/daughter to be able to do at home?
3. Following graduation, what do you think your son/daughter’s living situation will be?




At home Independently
At home with support
Apartment independently
Apartment with support
 Group home
 Own home
 Other_____________________
__________________________
4. In which of these independent living areas do you feel you son/daughter needs instruction in
this school year?
 Clothing Care
 Safety
 Meal Prep & Nutrition
 Sex Ed
 Hygiene/Grooming
 Household management
 Transportation
 Consumer skill
 Parenting/child care
 Community awareness
 Measurement
 Time management
Leisure/Recreation Questions:
1. What leisure/recreational activities does your son/daughter participate in alone or with friends?
2. What leisure/recreational activities does your son/daughter participate in with your family?
3. Are there any leisure/recreational activities in which you would like to see you son/daughter
participate?
4. What classes/activities would you like your son/daughter to participate into develop more
leisure interests?
Financial Questions:
1. Will your son/daughter have:
 Earned Income
 Insurance
 Food Stamps or general public
assistance
 Supplemental Social Security
(SSI)
General Questions:
 Social Security Disability
Insurance (SSDI)
 Trust/Will
 Other
1. What would you like the school staff to do to assist you in planning for your son/daughter
after graduation?