TRANSITION SERVICES (ADDRESS BY AGE 141/2)
Please include, if appropriate, needed linkages for outside agencies, (e.g., DMH, DRS, DSCC, PAS, SASS, SSI, WIC, DHCFS, etc.)
INSTRUCTION (e.g., tutoring, skills training, prep for college entrance exam, accommodations, adult basic ed.)
(If none, indicate “none”)
Provider Agency and Position
Goal #(s) if appropriate
Date/Year to be Addressed
Date/Year Completed
RELATED SERVICES (e.g., transportation, social services, medical services, technology, support services)
(If none, indicate “none”)
Provider Agency and Position
Goal #(s) if appropriate
Date/Year to be Addressed
Date/Year Completed
COMMUNITY EXPERIENCES (e.g., job shadow, work experiences, banking, shopping, transportation, tours of post-secondary settings)
(If none, indicate “none”)
Provider Agency and Position
Goal #(s) if appropriate
Date/Year to be Addressed
Date/Year Completed
DEVELOPMENT OF EMPLOYMENT AND OTHER POST-SCHOOL ADULT LIVING OBJECTIVES (e.g., career planning, guidance counseling, job try-outs, register to vote, adult benefits planning)
(If none, indicate “none”).
Provider Agency and Position
Goal #(s) if appropriate
Date/Year to be Addressed
Date/Year Completed
APPROPRIATE ACQUISITION OF DAILY LIVING SKILLS AND/OR
FUNCTIONAL VOCATIONAL EVALUATION (e.g., self-care, home repair, home health, money, independent living, / job and career interests, aptitudes and skills)
Provider Agency and Position
Goal #(s) if appropriate
Date/Year to be Addressed
Date/Year Completed
LINKAGES TO AFTER GRADUATION SUPPORTS/SERVICES (e.g. DRS, DMH, DSCC, PAS, SASS, SSI, WIC, DHCFS, CILs)
Provider Agency and Position
Goal #(s) if appropriate
Date/Year to be Addressed
Date/Year Completed