BCTCC Follow-Up Survey
I. GENERAL INFORMATION
1. Former Student's LAST Name
1. Former Student's FIRST Name
2. Street Address
2. Zip Code
3. Phone Number
5. Birthdate (mm/dd/yy)
6. What year did you graduate or leave school?
7. School District
American Indian or Alaskan Native
Asian or Pacific Islander
Black or African American (not Hispanic)
Hispanic or Latino
White (not Hispanic)
9. What is your disability (Please select all that apply)
Specific Learning Disability
Other Health Impairment
10. What is your gender?
11. Currently, are you...
Going to School
12. When you were in high school, what did you plan to do after high school?
College or other school
13. If your plans for after graduation changed, why did they change? (Please check all that apply)
Changed my mind about school, decided to go to work
Changed my mind about work, decided to go to school
Not enough money for school
Couldn't meet school or training entrance requirements
Started School, but quit
Started a job, but quit
Started a job, but was fired
Couldn't find a job
II. School or Training After High School
If your plan after high school was to go right to work, please skip ahead to Part III (Work After High School)
1. What type of school or training are you attending or have you attended?
Four year college
Two year college (e.g. RACC or other two year college program)
Career Technical or Business School (e.g. Stevens College of Technology, Hiram G. Andrews/Commonwealth Technical Institute, Allentown Business School, Empire Beauty School, Certification Programs)
Adult Day Program
2. Name (up to three) schools or traiing programs that you are attending or have attended. (Please also specify major)
3. What accommodations are you receiving or using - or have you received or used at any time after high school? (please check all that apply)
Reduced course load
Textbooks in Audio Format
Note taking assistance
Extended time for tests/written assignments completed in class
Personal screen reader (such as Kurzweil Reader)
Exams administered in quiet location
Use of apps
Other (please specify in box marked "Other" below)
III. Work After High School
If you have not held a job, please go to Section IV (Community Living)
1. How many paying jobs have you held since leaving high school?
More than 3
2. If you have left or changed jobs, Why? (Please check all that Apply)
Not Applicable (have only had one job-my current job)
For other employment
Terminated or fired
Didn't get along with coworkers or boss
Didn't have the skills
Change of boss or supervisor
Loss of benefits
Didn't receive needed accommodations
Didn't receive support from adult agencies
3. What type of work have you had? (Please check all that apply)
Paid minimum wage or more
Supported employment (paid work with a job coach)
Sheltered employment (where most workers have disabilities)
My own business
4. What is the job title of your curent (or most recent) job?
5. What is the name of the company you work for (or most recently worked for)?
6. What is your pay? If NOT currently working - what was your pay for your most recent job?
Minimum Wage ($7.25 per hour)
Above minimum wage
7. How did you get this job? (Choose all that apply)
Agency (AHEDD, OVR, Goodwill, Berks Personnel Network, KenCrest, CareerLink, Manpower, etc.)
IV. COMMUNITY LIVING
1. Where do you live? (Please choose all that apply)
With parents or guardian (permanent)
With a room mate
With significant other
With my child (or children)
With relative or sibling
Community Living Arrangement (CLA) residential
School dormitory or barracks (temporary)
2. What do you do in your free time? (Please check all that apply)
Go to the movies
Go to the community center
Go to church, synagogue, mosque
Hobby (Please specify hobbies below)
3. From what agencies have you received support? (Please check all that apply)
Office of Vocational Rehabilitation (OVR)
County mental health services (SAM)
County intellectual disabilities services (SAM)
County Children and Youth Services
Criminal justice system (probation or parole)
Health care clinic/medical consultation
County Assistance Office -welfare
4. Are there any activites that you would like to be involved in that you are not?
If yes, what activities? (Type under "Other")
5. If you answered YES to Question 4, what are the reasons you are not involved in activities of interest to you?
6. How do you get around for work or other activities? (Please check all that apply)
V. CLOSING QUESTIONS
1. What areas or parts of high school prepared you for your life after high school? (Please choose all that apply)
General education teachers
Special education teachers
Career & Technology Center
Extra curricular activities (sports, band, drama, etc.)
Working while in high school
Finding out what services are available to help me work or go to school after high school
Finding out how to ask for accommodations I need on the job or in school or training programs
Learning to describe my disability and strengths and ask for what I need (self advocacy)
Courses to get ready for life after high school
BCTCC website (Berks Transition.org)
2. Are you registered to vote?
I don't know
3. Are you registered with the Selective Service System?
No, I am a female and not required to registeredOption 3
I don't know
4. Do you need more information in the following areas?
College or training programs
Living in the Community
For more information on these topics - Visit our website at
. If you like, you can provide your contact information if you would like a volunteer from the Berks County Transition Coordinating Council to contact you. (Place in "Other" below.)
5. Berks County Transition Coordinating Council (BCTCC) is dedicated to improving transition services in Berks County. What suggestions do you have for better preparing youth for life after high school?
6. List any goals or future plans that you want to share.
7. THANK YOU so much for taking time to complete this survey. Your input is very important to us!
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