WorkAbility Survey

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WorkAbility Survey

2018-2019

Please take your time and answer carefully. The information you provide will be shared with your IEP team.

First name *

Last name *

Grade *

My cell phone or home number

Can I text you WorkAbility related information on this number?

Yes

Clear selection

My email (or parent's email) *

Who is my WorkAbility Employment Developer? *

Mrs. Prather

Mrs. Schreck

Mrs. Tostenson

My School *

El Dorado High School

Oak Ridge High School

Ponderosa High School

Union Mine High School

Virtual Academy

Independence High School

Here's what I do in my spare time (activities, sports, special interests and hobbies): *

I have worked the following places (paid or volunteer, or helping family, etc.)

Some things I'm considering for after high school are: *

Community College (Such as Folsom Lake College)

Enlist in the Military

Attend a Trade School (For example - Automotive, Culinary, Welding, Dental Assistant, Electrician, Cosmetology, Plumbing, Medical Assistant....plus many others!

4 year college

Work Full-Time

Undecided

Other:

Required

Some careers that sound interesting to me are: *

WorkAbility puts on several field trips each year. I would like to attend a field trip this year to visit/learn about:

Heavy Equipment Operator (Excavators, Cranes, Dozer)

Automotive Careers (mechanical and/or collision repair)

Sheet Metal and Heating and Air (HVAC) Careers

American River College or Sacramento City College (Community Colleges in Sacramento with lots of Career Programs)

Medical Career Training Programs - Medical Assistant, Pharmacy Tech, Nurse Assistant

Folsom Lake College (Seniors Only)

California Conservation Corps - Hiking Trail maintenance work, Firefighting Careers

Computer Science Careers

Trades - Drywall, Electrician, Construction Framing, Iron Workers, Carpenter, Plumbers, Construction Equipment Operator

Another place/program (list below):

Other:

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

Law Enforcement

Fire Control Technician

Animal Health

Auto Engine

Diesel Engine

Cosmetology

Culinary Arts

Dental Careers

Database Design & Programming

Health Careers

These Career Tech Education (CTE) courses sound interesting to me:

Only choose classes offered at your school

Agriculture (UMHS)

Digital Media (UMHS)

Desktop Publishing (UMHS)

Intro to TV Production (UMHS)

Engineering Design (UMHS)

Exploring Computer Science (UMHS)

Foods & Nutrition (UMHS)

Fashion Apparel & Textiles (UMHS)

Natural Resources (EDHS)

Environmental Botany (EDHS)

Woods/Carpentry (EDHS)

Medical Arts & Science (EDHS)

Culinary (EDHS)

Automotive Technology (EDHS)

I currently work at:

(leave blank if you don't have a job right now)

I can see myself working at: *

(somewhere around here, during high school)

What I am doing right now to help me reach my goals: *

I'm doing my homework

I'm studying for tests

I have a job

I do volunteer work

I have hobbies related to my future goals (explain below, under "Other")

I ask for help when I need it, from teachers, parents and other adults in my life

I'm taking an elective or class that relates to my career goals (explain below, under "Other")

Other:

Required

I learn best by... *

Hearing information (lecture in class, listening to directions, hearing a speech, etc.)

Hands on/Trying it myself

Seeing a demonstration or model (Youtube video, teacher demonstration)

Multisensory - a combination of seeing, hearing and doing

Other:

Required

Check any that apply to you: *

I have a resume I can use to apply for a job

I need help to create a resume

I'm thinking - "What's a resume???"

I have filled out a job application before

I have someone who can help me fill out job applications

I would like help at school to fill out a job application

Required

I have a driver's license or plan to get one in high school *

YES

Not sure

If I could have ANY job in the world, I would choose to be... *

Dream big! This is just for fun!

My school counselor is: *

My caseload (IEP) manager is: *

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