| Name: |
| Date: |
| Birth Date: |
| School: |
Profile:
|
Strengths:
|
Student's Vision
|
Goal #1 |
Short-term:
(over 6 months to 1 year) |
Long-term
(over 1 year to 5 years) |
| Post Secondary Education |
|
|
Skills and Abilities related to Post-Secondary Education/Training Goals:
|
Tasks to be Completed
to achieve goal |
Who is Responsible |
Date to Review
for Implementation |
| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
Goal #2 |
Short-term:
(over 6 months to 1 year) |
Long-term
(over 1 year to 5 years) |
| Employment/Volunteer |
|
|
Skills and Abilities related to Employment/Volunteer:
|
Tasks to be Completed
to achieve goal |
Who is Responsible |
Date to Review
for Implementation |
| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
Goal #3 |
Short-term:
(over 6 months to 1 year) |
Long-term
(over 1 year to 5 years) |
| Living in the Community |
|
|
Skills and Abilities related to Living in the Community:
|
Tasks to be Completed
to achieve goal |
Who is Responsible |
Date to Review
for Implementation |
| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
Goal #4 |
Short-term:
(over 6 months to 1 year) |
Long-term
(over 1 year to 5 years) |
Recreational/Social
Activities |
|
|
Skills and Abilities related to Recreational/Social Activities:
|
Tasks to be Completed
to achieve goal |
Who is Responsible |
Date to Review
for Implementation |
| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
Goal #5 |
Short-term:
(over 6 months to 1 year) |
Long-term
(over 1 year to 5 years) |
| Other |
|
|
Skills and Abilities related to this goal:
|
Tasks to be Completed
to achieve goal |
Who is Responsible |
Date to Review
for Implementation |
| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
