2017-18 Perkins My Transition Blueprint©️2017 versions A-S for students ages 13-22. Created 8-15-17
My Transition Blueprint
(All) Before you begin this survey, make sure your teacher or educational aide is with you and helping you through the questions. Is your teacher or another adult helping you with the survey?
(All) Take a moment to watch this 1 minute video that explains what TRANSITION means. Click on link below. After the video ends, close the window and return to answer the questions.
I watched the transition video
I skipped the transition video
(All) What is your FIRST Name?
type in your first name only--begin with a CAPITAL letter
(All) What is your LAST name?
type in your LAST name only--begin with a CAPITAL letter
(All) Which school building do you currently attend?
Perkins High School
Briar Middle School
EHOVE Career Center
Sandusky Central Catholic
(All) What is your birth date?
(All) What is your current age?
Choose age below
(All) In which year do you plan to graduate from high school?
Choose graduation year below
(All) When is your next IEP meeting?
(ask your case manager if you do not know the date of the meeting)
(All) When we meet to go over your IEP, is your IEP team also going to be reviewing a new ETR ? (Evaluation Team Report completed every 3 years)
(ask your case manager if you do not know this answer)
(All) What are your areas of need? Have your teacher help you identify your areas of need from the list below. Listed below are skills students need to succeed in a school and work settings. Check the skills that you and your teacher believe are your AREAS OF NEED.
AREAS OF NEED--select as many as apply
reading skills--the ability to read and understand what is read
writing skills--ability to write logical sentences and paragraphs
math skills--ability to calculate and solve math problems
listening comprehension--ability to listen to and understand others
oral expression skills--ability to verbally convey wants & needs & thoughts
test preparation/study for tests
big project completion
working with others/getting along with others
following the rules
asking for help
working without adult supervision
staying focused until a task is completed
giving a presentation in front of class
listening & following direction given by adults
(All) What do you and your teacher believe are your top 3 STRENGTHS? (list any school skills, social skills, work skills, personality traits, hands-on skills, etc. You may look at the list from the question above if you need help to start thinking of your different strengths, however you can list strengths not found on the list above--like "sense of humor" or "hard-working" or "respectful")
(All) How do you best learn a new task? What is your preferred learning style?
I learn best by READING about a new concept.
I learn best by LISTENING about or talking about a new concept
I learn best by SEEING or DEMONSTRATING a new concept.
(All) Do you believe you are ready to live on your own right now?
Honestly rate yourself on a scale of 1-10
No way! I still have lots to learn and lots of growing up to do.
Yes! I am totally ready & able to live on my own without parent/family support.
(All) Look at the independent living skills below and choose the skills that you STILL NEED TO LEARN or IMPROVE UPON before you will be ready to live on your own.
Need to learn to organize own schedule for work & bill paying & school & classes
Need to learn to ask for help and how to ask for help from others when needed
Need to learn to do own laundry
Need to learn to do own housekeeping/cleaning
Need to learn how to keep track of monthly bills
Need to learn how to set up budget so income is more than money spent
Need to get drivers license
Need to learn how to use public transit like STS
Need to learn how to make own medical & dental appointments
Need to learn how to renew and refill own prescriptions
Need to learn how to shop for food & clothes & household supplies
Need to learn how to prepare meals
Need to learn how to use social media like Facebook & Instagram & Snapchat safely
Need to learn to use the internet to search for helpful information to solve problems of adult living
Need to learn how to use credit cards and debit cards safely
Need to learn how to make online purchases safely and responsibly
Need to earn an income large enough to support living independently
Need to learn how to make friends and maintain healthy friendships
Need to learn how to maintain good grooming and hygiene
Need to learn how to use personal smart phone safely and responsibly
(All) After graduation from high school (within 6 months) in which of these settings do you think you will be living?
Choose one setting from the list below
at home with family until ready to move out on own
in an apartment with a friend
in an apartment of own
on a college campus in a dorm room
on a military base
(All) Which grade are you in currently?
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