Student Name_________________

FSS

Graduation Transitions

Document

Transition Plan is YOUR plan for the future. It includes your skills,

interests and abilities joined together into a plan. You may

already know where you are headed but then again may be

completely lost. This plan should help point you in the right

direction. It is about transitioning into the “REAL WORLD”, the

world after High School.

TRANSITION PLAN

Your transition plan is an exploration and documentation of

your plans beyond your life as a secondary school student.

Consider the following questions:

What are you planning to do?

Work/employment, skills upgrading, post-secondary

education, training etc….

Where will you pursue your plan?

Are you staying in Fernie? Moving to another

community?

Why have you decided on that particular route?

What interests, aptitudes, skills led you to this

decision?

How will you fulfill your plan?

You will document finances, supports, and

preparation.

To create your transition plan you will be using information from

prior learning activities, which you completed in: Planning 10,

Career Prep. Program, Post Secondary Career Exploration, and

various other courses.

Assessment: Completed transitions documents will be recorded

as an “RM” letter grade (requirements met) on your transcripts.

NOTE:

Please hand in to Mrs. Christenson at the OFFICE.

STUENT NAME: _______________________________

Graduation Transitions Checklist

Personal Health & Activity

Physical Activity Log …………………………………………………

Healthy Living Plan (Canadian Food Guide Activity)...............

Emotional Health (How stressed are you?)………………………

Reflection …………...………………………………………………..

Career and Life

Career Exploration activity.........................................................

Current Resume (reference letter (if available)......................

Copy of a workforce application, application to a post-

secondary institution, or acceptance letter………………..

Financial Plan.............................................................................

Reflection ....................................................................................................................................

Community Connections

Identifying fundamental skills activity......................................

Reflection work/volunteer & community................................

Workplace Evaluation………………………………………….....

Documentation (30 hrs) of work or volunteer experience…

Fernie Secondary School

Graduation Transitions

Personal Health & Activity Develop a healthy living plan appropriate to your lifestyle

that describes: sound nutritional habits, regular exercise

routines, emotional health management, and positive

health decisions.

1) Participate in and document 150 minutes per week

at each grade from 10-12 (regular physical activity in

addition to PE 10). Documentation may include a

fitness journal, record of PE attendance, confirmation

from coaches, instructors, certificates, etc. as to the

type of activity and number of hours completed.

(forms are included).

2) Google Canada’s Food Guide

http://www.healthycanadians.gc.ca/eating-

nutrition/healthy-eating-saine-alimentation/food-

guide-aliment/my-guide-mon-guide/mfg_p1-

eng.php

“Eating Well with Canada Food Guide” and

complete the activity “Create My Food Guide” found

under the title “My Food Guide: Interactive tool”.

Print your completed personal food guide and

include it with this package.

3) Emotional Health is as important as physical health

to the well being of all individuals. Complete the

activity “How Stressed are You” and follow up with

the suggestions listed in the “Ways of Dealing with

Stress”.

4) Write a short reflection piece on your plans for

sustaining the choices you have made to support a

healthy lifestyle.

PERSONAL HEALTH AND ACTIVITY

PERSONAL HEALTH - DAILY PHYSICAL ACTIVITY

Effective September 2008, the Ministry of Education requires

that all Grade 10 -12 students document and report a

minimum of 150 minutes (2.5 hours) per week of physical

activity, at a moderate to vigorous intensity, as part of their

Graduation Transitions Program.

Students can document this in two ways. The first is a paper

version, which will require documenting and describing all

physical activities participated in. Activities may include

anything from participating in team sports, to walking your

dog.

The second method of documenting can be done online

through LearnNowBC (LNBC). First time users to LNBC will

be required to sign up before they can access the Daily

Physical Activity (DPA) application.

Sign up is done at the LNBC URL at www.learnnowbc.ca.

Follow the instructions to create an account. LNBC offers a

variety of Student Services including Course Finder, Tutoring,

Academic Advising, Daily Physical Activity and Libraries.

Click on the DPA icon, and follow the instructions. Once

completed, the log of DPA can be printed and included in the

Transitions Package.

Remember, this section is supposed to be meaningful and

benefit your health now and in the future. Please make an

effort to choose activities that you enjoy and will possibly

become a part of your lifelong physical activity routine.

PERSONAL HEALTH AND ACTIVITY

NAME: ___________________________

An expectation of the “Graduation Transitions” program is at least

150 minutes of regular physical activity per week.

This requirement of physical activity can be met through....

A. Completion of PE 11

Year _________ Semester___________ Teacher___________

B. Completion of PE 12

Year _________ Semester___________ Teacher___________

C. Participation in FSS extracurricular sport OR community sport

activity

Team/Sport________________________________________________

Year(s)________/Grade(s)__________

Months Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug

Coach/supervisor:_____________________ Phone:_________________

Team/Sport________________________________________________

Year(s)________/Grade(s)__________

Months Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug

Coach/supervisor:_____________________ Phone:_________________

Team/Sport________________________________________________

Year(s)________Grade(s)___________

Months Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug

Coach/supervisor:_____________________ Phone:_________________

PERSONAL HEALTH AND ACTIVITY (Continued)

D. Participation in a recognized Fitness Club or Program

Please document other physical activity for grades 10 to 12, which

does not fit into the above categories. Please include year and

grade, and a supervisors name if applicable.

Club/Organization_______________________________________________

Year(s)________/Grade(s)_________

Months Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug

Trainer/supervisor:_____________________ Phone:_________________

CANADA FOOD GUIDE

Google Canada’s Food Guide

http://www.healthycanadians.gc.ca/eating-

nutrition/healthy-eating-saine-alimentation/food-guide-

aliment/my-guide-mon-guide/mfg_p1-eng.php

“Eating Well with Canada Food Guide” and complete

the activity “Create My Food Guide” found under the

title “My Food Guide: Interactive tool”. Print your

completed personal food guide and include it with this

package.

Please be sure to put your name on this and attach to back of this

package!

HOW STRESSED ARE YOU?

Count any item that happened in the last 12 months.

The Stress Event

Values

Death of a parent, sibling, boyfriend/girlfriend 100

Divorce of your parents 65

Puberty 65

Pregnancy or causing pregnancy 65

Break-up with boyfriend/girlfriend 60

Jail term or probation 60

Death of an extended family member 60

Serious personal injury or illness 45

Change in independence or responsibility 45

Any drug / alcohol use 45

Fired at work or expelled from school 45

Change in alcohol or drug use 45

Reconciliation with family, boyfriend/girlfriend 40

Trouble at school 40

Serious health problem of a family member 40

Working while attending school 35

Working more than 40 hours per week 35

Change in Frequency of dating 35

Gain of a new family member (baby born, parent remarries) 35

Change in work responsibilities 35

Death of a friend 30

Change in the number of arguments with family or friends 30

Sleep less than 8 hours per night 25

Trouble with boyfriend’s/girlfriend’s family 25

Outstanding personal achievement (awards, grades etc.) 25

Parents start or stop working 20

Begin or end school 20

Change in living conditions (visitors in house, remodeling) 20

Change in personal habits (start or stop smoking, dieting) 20

Chronic allergies 15

Change in residence 15

Change in religious activity 15

No money 10

Change in frequency of family gatherings 10

Vacation 10

Presently in the winter season of the year 10

Minor violation of the law 5

TOTAL: ___________

Any score of over 250 means you are stressed … please refer to the following page.

WAYS OF DEALING WITH STRESS

IF YOU ARE SHOWING SIGNS OF STRESS, IT CAN NEGATIVELY AFFECT YOUR PHYSICAL AND MENTAL HEALTH. PLEASE LOOK AT SOME OF THE SUGGESTIONS LISTED BELOW TO HELP REDUCE STRESS.

1. RE-SET YOUR BODY CLOCK Set yourself a reasonable wake-up time and bedtime. Stick to it. Allow up to 3 weeks to re-set your body clock. ** During the daytime get some exposure to natural light.

2. GIVE YOURSELF A BREAK TODAY Repair and regenerate. Every morning prioritize a list of everything that needs to be done. “Then cut the bottom half off the list.”

3. LIGHTEN UP YOUR LOAD OF SOCIAL ENGAGEMENT (Say “no”) 4. POSTPONE A CHANGE IN YOUR LIVING ENVIRONMENT

Change = Stress. Even good change adds stress.

5. NO MORE THAN 40 HOURS/WEEK AT WORK OR SCHOOL 6. KEEP BLOOD SUGAR LEVELS STEADY

Avoid the highs and lows caused by sugar, candy, caffeine & alcohol. ** Choose cereal, pasta, bread & rice: they will provide a slow even release of sugar. Eating vegetables will increase the production of “serotonin” a happy messenger.

7. ALLERGIES Avoid foods or any items that may trigger your allergies.

8. EXERCISE This will give the nerve cells in the brain a chance to rest (stop worrying). Rest your mind: choose music, art, read, create etc.

9. RESIST THE USE OF DRUGS AND TRANQUILIZERS They may block out the overstressed feelings short term but can do long term damage.

10. TAKE SEVERAL 30-SECOND BREAKS TO LOOK OUT THE WINDOW OR STRETCH

11. MEDITATE, OR PRACTICE A RELAXATION TECHNIQUE LIKE YOGA, OR TAI CHI.

12. HUG YOUR FAMILY AND FRIENDS

13. SEEK COUNSELLING OR MEDICAL HELP

PERSONAL HEALTH AND ACTIVITY REFLECTION

(Physical activity, good nutrition and healthy choices

contribute to the overall well being of individuals. How

does this statement apply to you?)

Reflection:

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

Fernie Secondary School

Graduation Transitions

Career and Life

You are responsible for planning and preparing your

education, career, and life goals through Graduation

Transitions. Who are you? What are your interests/skills?

1. Complete the career exploration activity found

attached.

2. Complete and include a current resume. Include a

reference letter if available/applicable. You may

want to refer to the Resume Writing summary located

further in your package.

3. Include and complete a copy of an application to a

post-secondary institution or workforce application.

4. Complete the financial plan activity found near the

end of this package.

5. Reflection on the Career and Life activities.

CAREER AND LIFE Future Career Assignment

Open the website https://www.jobbank.gc.ca/quizhome YOU DO NOT NEED TO CREATE AN ACCOUNT Under Explore Occupations you will be required to do the following quizzes – Abilities Quiz / Data, People and Things / Work Preference Quiz. Under Explore Personality you will be required to do the following quizzes – Multiple Intelligence Quiz / Learning Syles Quiz / Work Values Quiz.

Begin with the Abilities Quiz. There are 39 questions. Answer each question to the best of your ability. When completed, answer “How much Education” and click on ‘Get Results’. List your top 3 Abilities and your percentage identified? 1.________________________________________________________________________/____% 2.________________________________________________________________________/____% 3.________________________________________________________________________/____% Next is the Data/People/Things Quiz. There are 4 questions. Answer each question to the best of your ability. When completed, answer “How much Education” and click on ‘Get Results’. Which order describes your preference and ranking. Rank 1__________________________________________________________ Rank 2__________________________________________________________ Rank 3__________________________________________________________ Choose the Work Preference Quiz. There are 50 questions. Answer each question to the best of your ability. When completed, answer “How much Education” and click on ‘Get Results’. Which ones are your top 3 Preferred Methods of Work and your percentage identified? 1.________________________________________________________________________/____% 2.________________________________________________________________________/____% 3.________________________________________________________________________/____% Now scroll to the Multiple Intelligence Quiz. There are 64 questions. Answer each question to the best of your ability. When completed, answer “How much Education” and click on ‘Get Results’. Which ones are your top 3 Types of Intelligence and your percentage identified? 1.________________________________________________________________________/____% 2.________________________________________________________________________/____% 3.________________________________________________________________________/____% Choose the Learning Styles Quiz. There are 24 questions. Answer each question to the best of your ability. When completed, answer “How much Education” and click on ‘Get Results’. Which ones are your top 3 Preferred Learning Styles and your percentage identified? 1.________________________________________________________________________/____% 2.________________________________________________________________________/____% 3.________________________________________________________________________/____% Finally, complete the Work Values Quiz. There are 33 questions. Answer each question to the best

of your ability. When completed, answer “How much Education” and click on ‘Get Results’.

Describe one preference that suits you best under ‘Your Work Motivations’.

________________________________________________________________________

Describe one preference that suits you best under ‘Your Preferred Work Setting’.

________________________________________________________________________

Describe one preference that suits you best under ‘How You Interact with Others’.

_______________________________________________________________________

Describe one preference that suits you best under ‘My Work Style’.

________________________________________________________________________

Future Career Assignment (continued) On the Career Quizzes page, you will see a heading titled ‘Occupations that match your results

from all quizzes combined’.

Find a career that interests you and click on it. Name the career and give a brief description of the

job and duties identified.

Name of career __________________________________

Description______________________________________________

________________________________________________________________________

List the Employment Requirements (education, work experience, etc.)

________________________________________________________________________

Scroll and find ‘Work Places/Employers’. List 3 of the places you may find work with the career

mentioned above.

1.__________________________________________

2.__________________________________________

3.__________________________________________

On the right there is a column titled ‘Explore Careers’.

What is the Growth Rate (Outlooks Search) by % of this occupation compared to all other

occupations?

This occupation ____% / All occupations____%

Find the box titled ‘Wages’. What, is the Median Hourly Wage compared to all other occupations?

This occupation ______ / All occupations ______

List 3 Related Occupations

1._____________________________________________________________

2._____________________________________________________________

3._____________________________________________________________

There is a link titled ‘Career Tool Factsheet’ the contains some very good information. If you are

interested in further information about this career or any other, you can go to the following

WorkSafeBC site. http://www.worksafebc.com/careers/job_profiles/default.asp.

Hopefully you have learned how to fully investigate a career and may use either of these websites

again.

Career and Life

LIFESTYLE REALITY CHECK

Name: __________________________________

Typical costs per month for BC Youth

after high school Large City/ Rest of Your Budget Lower Mainland B.C.

HOUSING At home with parents ________ 150 150

One-bedroom apartment ________ 945 520

Share two-bedroom apartment with roommate ________ 510 325

TRANSPORTATION

New car (Toyota Matrix) ________ 1,014 996

Used car ( Honda Civic Dx) ________ 573 533

Public transport ________ 87 45

FOOD

Eat at apartment only ________ 200 200

Eat out occasionally ________ 300 300

UTILITIES

Electricity ________ 24 24

Heat – electric ________ 40 35

Heating – gas/oil ________ 30 30

TELEPHONE

Basic service only ________ 31 26

Long distance (talk a little) ________ 5 5

Long distance ( talk a lot) ________ 20 20

Cellphone (local) ________ 40 40

COMPUTER

Hardware ________ 90 90

Software ________ 25 25

Internet connection ________ 35 35

CLOTHING

Shop a little ________ 40 40

Shop a lot ________ 175 175

HEALTH CARE

Medications and dental ________ 30 30

Glasses/lenses ________ 10 10

INSURANCE

Medical premiums (if not under parents’ plan) ________ 54 54

Apartment contents insurance ________ 17 17

SUB-TOTAL ________

Career and Life R AND LIFE ntinuedLIFESTYLE REALITY CHECK (continued)

ENTERTAINMENT

Cable (basic) _________ 30 30

Movies (with popcorn, etc.) ________ 51 48

Rentals: video/DVD/games ________ 30 30

Purchases: Music ________ 30 30

Purchases: video/DVD/games ________ 18 18

Concerts and professional sports ________ 45 45

Night Clubs ________ 60 60

RECREATION

Sports fees/equipment ________ 16 16

Lessons ________ 15 15

Helath club membership ________ 45 37

PERSONAL

Haircut: Men ________ 20 15

Haircut: Women ________ 30 28

Manicures, etc. ________ 20 20

Makeup ________ 30 30

Personal Care (shampoo, soap, etc.) ________ 15 15

Dry cleaners ________ 20 15

Laundry at Laundromat ________ 20 20

Cigarettes ________ 69 69

Alcohol ________ 45 45

EDUCATION (tuition, fees, books, etc/12 months)

University ________ 475 475

College/University College ________ 390 390

Technical ________ 530 530

OTHER

Banking Fees ________ 6 6

Newspapers ________ 20 20

Books/magazines ________ 15 15

Religious/Charity ________ 5 5

Gifts ________ 20 20

Pets _________ 15 15

Bottled water service ________ 31 28

New furniture (averaged over year) ________ 200 200

Used furniture (averaged over year) ________ 75 75

Travel: low-cost vacation by car (save per month) ________ 35 35

Travel: vacation including plane fare (save per month) ________ 200 200

Enter missing expenses here:

_____________________________________________ ________

_____________________________________________ ________

TOTAL EXPENSES: _______________

Career and Life CAREER AND LIFE (continued)

RESUME WRITING

A resume is a summary of your education, employability history, and

accomplishments. The purpose of a resume is to summarize aspects

that are relevant to an employer. It is usually sent with a cover letter

to a potential employer in order to generate interest and an

interview. The resume must hold the reader’s attention and create a

positive, lasting impression of the writer.

Basic rules of presentation

No spelling mistakes (ever)

Layout and spacing must be clear and easy to read.

Style, spacing, tabs, font, etc., must be consistent.

Your name should be at the top of each page.

You must always ask someone to be a reference for

you. Don’t assume they will know.

Everything in your resume must be truthful.

The following should help you organize your resume. Things to

include:

Name:

Address: (mailing)

Telephone: (home) (cell)

Skills (minimum of 4)

Education: (grade enrolled in now)

Other certificates: (if any)

Work Experience: (if any, list all that may be applicable)

Include Employer, Dates employed and responsibilities

Volunteer Experience (if any)

Interests/Hobbies (minimum of 3)

References (must list 3 work related or personal)

Include Name, Business Name, Address, and Telephone

number (home, work, cell).

CAREER AND

Career and Life

(What plans have you made for after high school? What

are your thoughts about your future? Are you excited

about the possibilities and opportunities out there?)

Reflection:___________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

Fernie Secondary School

Graduation Transitions

Community Connections Participate in at least 30 hours of work experience and/or

community service. This may include part-time

employment, volunteer activities, conference involvement

or job shadowing.

1. Complete the Skills Assessment and the

Transferable Skills Activity.

2. Write a short reflection piece on the benefits that

you received from participating in work or

volunteer experience.

3. Participate in and document a minimum of 30

hours of work or volunteer experience. Fill out and

submit the work experience log.

Have the workplace evaluation completed and

returned attached to this document.

SKILLS ASSESSMENT

Rate your current competency in each skill listed below on a scale of

1 to 5 (5 being a high skill level).

SPEAKING – Ability to express oneself effectively in

individual and group situations.

LISTENING – Ability to listen actively for messages and

feelings and to pick out important information in oral

communications.

WRITING – Ability to express ideas in a clear, concise,

grammatically correct and appealing manner.

READING – Ability to acquire facts and to understand

the meaning in written communications.

ANALYZING SITUATIONS – Ability to interpret available

information about a situation, concept or problems.

JUDGEMENT – Ability to effectively evaluate situations

and information and reach logical conclusions.

DECISIVENESS – Readiness to make decisions.

PLANNING AND ORGANIZING – Ability to effectively plan

and organize one’s own work plus direct and assist

others in planning and organizing their work.

DELEGATING – Ability to delegate tasks clearly and

effectively while encouraging input and efficiency from

subordinates and promoting their development.

DEVELOPING STAFF – Demonstrated ability to develop

staff by coaching, training, role modeling, mentoring

and supporting.

NEGOTIATION – Ability to successfully reach agreement

with others in a manner which supports the best interest

of the company and reflects respect for and interest in

the other party.

CONTROLLING – Ability to use administrative controls

effectively for monitoring and assessment functions.

LEADERSHIP – Ability to motivate a group or individual to

effectively accomplish a task.

FLEXIBILITY – Ability to modify one’s own approach and

behaviour as needed.

INTERPERSONAL SENSITIVITY – Awareness and

consideration of the needs and feelings of others.

INITIATIVE – Ability to motivate oneself to take positive

action.

CREATIVITY – Ability to generate imaginative solutions for

problem situations.

SKILLS ASSESSMENT - Continued

Rate your current competency in each skill listed below on a scale of

1 to 5 (5 being a high skill level).

ENTHUSIASM – Ability to maintain a positive outlook and a positive approach to

problem solving and to demonstrate interest and

commitment.

ENERGY – Ability to approach one’s work activities with

vigor, action and interest.

COOPERATIVENESS – Ability to work effectively with

others and to respect differences.

RELIABILITY – Ability to attend work regularly, be

punctual, follow through on commitments and meet

deadlines.

SELF-DEVELOPMENT – Developing skills in order to be

more effective; obtaining feedback for further

development.

REGARD FOR OTHERS – Ability to respect the work and

dignity of others regardless of nationality, religion, age,

sex, marital status, or other areas of difference.

STRESS MANAGEMENT – Ability to cope effectively with

situations and workload, maintaining a balance in life

through effective use of leisure/recreation time.

Which 3 skills would you like to improve?

1. _____________________________________________

2. _____________________________________________

3. _____________________________________________

TRANSFERRABLE SKILLS

Go through the transferable skills on this page and check off all the

ones you have.

WORKING WITH COMMUNICATION SKILLS LEADERSHIP SKILLS

PEOPLE SKILLS

____ assisting ____ advising ____ administering

____ coaching ____ communicating ____ coaching

____ consulting ____ interpreting ____ conducting

____ cooperating ____ persuading ____ controlling

____ counselling ____ promoting ____ deciding

____ enforcing ____ presenting ____ directing

____ helping ____ reading ____ facilitating

____ instructing ____ summarizing ____ influencing

____ serving ____ talking ____ initiating (starting)

____ teaching ____ translating ____inspiring

____ training ____ writing ____ leading

____ managing

____ motivating

____ negotiating

WORKING WITH ____ planning

INFORMATION AND CREATIVE SKILLS: ____ recognizing

NUMBER SKILLS ____ arranging ____ reinforcing

____ cooking ____ rewarding

____ analyzing ____ creating ____ supervising

____ budgeting ____ demonstrating MANUAL AND

____calculating ____ designing MECHANICAL SKILLS

____ checking ____ developing ____ adjusting

____ evaluating ____ devising ____ constructing

____ inspecting ____ generating ____ installing

____ memorizing ____ improvising ____ operating

____ ordering ____ inventing ____ repairing

____ organizing ____ inventing ____ servicing

____ researching ____ originating

____ reviewing ____ performing

____ scheduling ____ producing

____ selecting ____ predicting

____ verifying

Which group has the most skills for you? ______________________________________

Is this an accurate reflection of you? _______________________________________

COMMUNITY CONNECTIONS (Work/Volunteer Experience )

(Describe how your work experience related to your future

career plans, prepared you for the work world or provided

you with job skills.)

Reflection:

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

____________________________________________

_________________________________

COMMUNITY CONNECTIONS

An expectation of the “Graduation Transitions” program is

participation in at least 30 hours of work experience and/or

community service. This may include part-time employment,

volunteer activities, conference involvement or job shadowing.

A. Placement Details

Name of

company/employer/sponsor___________________________________

Job or assignment

_____________________________________________________

Address: _______________________Phone: _________________________

B. Type of Career experience

____Employment ____Voluntary

____Job Shadowing ____Self-Employment

Give Details of your RESPONSIBILITIES: (be specific)

__________________________________________________________________

C. Job Preparation (Training? What did you need to learn in

order to start this placement?)

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

FERNIE SECONDARY SCHOOL – Assessment for Grad Transitions

EVALUATION BY SUPERVISOR/EMPLOYER (FOR ALL PLACEMENTS):

This evaluation is to verify and assess the student named below in your

place of work. Please complete and return to the student.

Student’s Name: _______________________________________________

1. Is punctual negative 1 2 3 4 5 positive

2. Displays a friendly attitude negative 1 2 3 4 5 positive

3. Is enthusiastic negative 1 2 3 4 5 positive

4. Comes prepared to work negative 1 2 3 4 5 positive

5. Cooperates with others negative 1 2 3 4 5 positive

6. Is polite and courteous negative 1 2 3 4 5 positive

7. Is reliable in following through negative 1 2 3 4 5 positive

8. Is self-reliant negative 1 2 3 4 5 positive

9. This student has completed more than 30 hours of work or volunteer

experience? Yes /No

Additional comments:

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Name (please print): ___________________________________________________

Position_________________________________________________________________

Signature______________________________________ Date: ___________________