WorkAbility Survey
2019-2020

Please take your time and answer carefully. The information you provide will be shared with your IEP team.
First name *
Your answer
Last name *
Your answer
Grade *
My cell phone or home number
Your answer
Can I text you WorkAbility related information on this number?
My email (or parent's email) *
Your answer
Who is my WorkAbility Employment Developer? *
My School *
Here's what I do in my spare time (activities, sports, special interests and hobbies): *
Your answer
I have worked the following places (paid or volunteer, or helping family, etc.)
Your answer
Some things I'm considering for after high school are: *
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Required
Some careers that sound interesting to me are: *
Your answer
WorkAbility puts on several field trips each year. I would like to attend a field trip this year to visit/learn about:
These Regional Occupation Program (ROP) courses sound interesting to me:
These courses are offered at different campuses, and you must have your own transportation to attend
I currently work at:
(leave blank if you don't have a job right now)
Your answer
I can see myself working at: *
(somewhere around here, during high school)
Your answer
What I am doing right now to help me reach my goals: *
Required
I learn best by... *
Required
Check any that apply to you: *
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Required
I have a driver's license or plan to get one in high school *
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If I could have ANY job in the world, I would choose to be... *
Dream big! This is just for fun!
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Your answer
My school counselor is: *
My caseload (IEP) manager is: *
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