Plans for the Future
Student Name: ______Date of Birth: ______
School: ______Grade: ______
Today’s Date: ______
Careers
What year do you plan to leave high school? ______
Which of the following options would you like to be doing after
leaving high school? Check as many items as you wish.
o Job
What kind of job? ______
What kind of help, if any, will be needed to get/keep this job?
______
o Further job training (technical/trade school)
o Military
o Community College or University
What kind of help, if any, will you need to go to college?
______
o Homemaker
o Volunteer services
o Other ______
Living Arrangements
Where do you want to live after leaving high school?
Immediately Long Term
With parents or relatives o o
In your own apartment or home o o
In a group home o o
Other living options – Immediate ______Long Term ______
What type of help, if any, will be you need to live in these environments?
______
Community Living and Transportation
How will you travel to your job or school? ______
How will you travel to community activities? ______
Where will you get money to live in this community? ______
Recreation, Leisure and Social Activities
What do you like to do in your free time?
When alone: ______
With a group (e.g., family, church, school): ______
Community (e.g., movies, shopping, eating out): ______
What kind of help, if any, will you need to participate in social and
recreational activities? ______
What kind of recreational or leisure activity would you like to learn? ______
______
School Program
Are you getting vocational training in real work settings? Yes _____ No _____
What kind of work would you like to be doing during the next school year?
______
Are you learning to be more independent? Yes ______No ______
Are you receiving instruction outside of school? Yes ______No ______
If YES, describe the type of instruction ______
What do you need to know to help you live more independently in the community?
______
What kind of help do you need at school to be successful? ______
______
Are you participating in extra-curricular/after-school activities? Yes _____ No _____
If YES, describe the activities ______
Agency Involvement
Check all the services that you think you may need now and in the future
to be successful in the community. Check as many boxes as you necessary:
Now Future
Job training/support o o
Income support o o
Medical services o o
Transportation o o
Community skills training o o
Other services - Now ______Future ______
Student Signature: ______
CKSEC 2004