Office of Special Education
Transition Survey
PARENT/Guardian Survey for Transition Planning
Date of Completion:
Student Name:
Date of Birth:
Parent/Guardian Name:
Respondent Name (if different from parent):
Address:
Phone Number:
School:
Grade:
Anticipated Exit Date:
This survey addresses what you anticipate to be your student’s needs when he/she finishes high
school. This information will also serve as a guide to your student’s teachers in deciding which
classes and educational experiences/supports he/she should have to help successfully transition
from high school to the desired post-secondary environment.
Please complete the following information by checking all that is applicable.
Post Secondary Education or Training
Attend 2 or 4 year college or university
Attend Vocational/Technical School
Military
My student does not intend to pursue postsecondary education
Other (Please specify
Coweta County School System
2/17/2016
1
Office of Special Education
Transition Survey
Vocational Training
Please answer the following questions:
What kind of work do you think your student would enjoy/find interesting?
What kind of work do you think your student would not enjoy or find interesting?
I anticipate my student will:
Work full-time
Work part-time
Participate in volunteer work
Not work or participate in community activities due to
I anticipate my student will need the following (check all that apply):
No known needs; should be able to work independently
Career counseling
Long term support to maintain employment
Special modifications or accommodation such as equipment/devices
Sheltered workshop or similar arrangement
Other (please specify)
Not sure
Coweta County School System
2/17/2016
2
Office of Special Education
Transition Survey
Post-School Living Arrangements
I anticipate my student will live:
`
With parents or other relatives indefinitely
With parents or other relatives for a while but eventually on his own
In his own apartment/home or similar arrangement with roommate(s)
In a group home
Other living options or arrangements (Please specify)
Not sure at this time
Transportation
I anticipate my student:
Will drive self to work and other activities
Will carpool with co-workers or friends
Will use public transportation
Will walk unsupervised to work and activities
Will need transportation to all activities
Recreation and Leisure Activities
In what post-school recreation/leisure activities would you like to see your student participate,
and what is the current level of independence?
Activity
Current Level of Independence
Attend movies, plays
with family
with peers (no adult supervision)
Attend sporting events
with family
with peers (no adult supervision)
Use public library
with family
with peers (no adult supervision)
Play informal games
with family
with peers (no adult supervision)
Participate in sports
with family
with peers (no adult supervision)
Other (please include current level of independence)
Coweta County School System
2/17/2016
3
Office of Special Education
Transition Survey
Independent Living Skills
I anticipate my student will need assistance with (please check all that apply):
Personal care (grooming, dress, hygiene)
Money management (banking, purchases, budgeting)
Cooking/meal planning
Household maintenance
Personal health and accessing medical assistance
Communication skills
Personal safety
Using community organizations and activities
Maintaining friendships and personal relationships
Other (please specify)
Other Services
Please list all the non-school agencies and services that you anticipate your student will access
to be successful when he/she leaves high school. (For example: Vocational Rehabilitation;
Coweta County Health Department; Social Security, Department of Parks and Recreation, etc)
1.
Currently receives services
2.
Currently receives services
3.
Currently receives services
4.
Currently receives services
5.
Currently receives services
Coweta County School System
2/17/2016
4