Student Name Justin B.

School Albemarle High Year 2015-16

INDIVIDUAL TRANSITION PLAN

(Completed on the first IEP in which the student is 15)

TRANSFER OF RIGHTS AT AGE OF MAJORITY (AGE 18)

(CHOOSE ONE)
The student has been informed that the IDEA rights transfer to him/her at age 18
and has been provided with an explanation of those procedural safeguards on
(date). This procedure should occur when the student is 16 years of age.
The student was informed of transfer of rights in a previous IEP Meeting.

ANTICIPATED GRADUATION STATUS

Regular Diploma

Modified Standard Diploma

IEP / Special Diploma

Check that the issue below to indicate that it has been considered by the
IEP Team.
For a student pursuing a modified diploma, consider the need for occupational readiness
upon school completion, including consideration of courses to prepare the student as a
career and technical education completer.

Expected Exit Date or Date of Graduation: 05/2016

TERMINATION OF SERVICES UPON GRADUATION

(CHOOSE ONE)
This student is not scheduled to graduate next year. This student is eligible to
receive services through age 21 (have not reached their 22 nd birthday on or before
September 30). The student would exit the special education program noted in
Anticipated Graduation Status above, provided (s)he has not received a regular or
advanced diploma.
This student is scheduled to graduate with a Special Diploma. However, this
student is eligible to receive services through age 21 (have not reached their 22 nd
birthday on or before September 30) provided (s)he has not received a regular or
advanced diploma.
This student is scheduled to graduate with a regular or advanced diploma on
5/2016
At that time this student will have met all Albemarle County Public Schools and
Form 60.04 ( Revised - 2/2005 ) Page 1 of 6

Commonwealth of Virginia requirements for a regular or advanced studies diploma.

The awarding of such diploma will terminate all special education and related
services for this student in Albemarle County Public Schools.
This student is scheduled to age out of his/her special education program. That is, this
student is ineligible to receive services because they have reached their 22nd birthday on or
before September 30.

Form 60.04 ( Revised - 2/2005 ) Page 2 of 6

Student Name Justin B.

School Albemarle High

Year 2015-2016

COURSE OF STUDY:
Describe the students educational program. Be sure to include student interests.
Justin is taking courses towards his standard diploma. He is fond of history and tae kwon do.
Justin has a strong proclivity for writing.

POST-SECONDARY GOALS
COMPLETE THIS SECTION WITH THE STUDENT
MEASURABLE POST-SECONDARY GOAL(S) for
Will perform what skill?

My (the student) goal for postsecondary training is to receive

any necessary job orientation
and job training support skills as
part of his employment process.

TRAINING:

At what level?

on site
training

In what
context?

indepen
dent
living

How will it be
measured?

By what date
or timeframe?

feedback
from
agency/s
tudnet

graduation

Assessment used to determine goal: student interview

These are the services and/or coordinated

activities that will help you, the student,
achieve your goal for post-secondary
training.

A referral to Woodrow Wilson will be made to

participate in training/internship program. Participate
in pre-vocational activities in the school/classroom.

MEASURABLE POST-SECONDARY GOAL(S) for

Will perform what skill?

My (the student) goal for postsecondary education is to attend

Piedmont Virginia Community
College then transfer to a 4 year
university.

Person or
Agency
Responsible

Timeline
for
Completion

DRS

upon
graduatio
n

Completed

Yes:
No:
Comment:

EDUCATION:

At what level?

In what
context?

collegiate parttime

How will it be
measured?

grades

By what date
or timeframe?

fall
semester
following
HS
graduation

Assessment used to determine goal: student interview; parent interview

These are the services and/or coordinated

activities that will help you, the student,
achieve your goal for post-secondary
education.

Participate in practice SAT/ACT, receive contact

info. for disability services at college, shadow a
college day, meet with guidance counselor/career
Form 60.04 ( Revised - 2/2005 ) Page 3 of 6

Person or
Agency
Responsible

Dept. of
Vocational
Rehab

Timeline
for
Completion

Spring
Semester

Completed

Yes:
No:
Comment:

center staff for planning and support

Form 60.04 ( Revised - 2/2005 ) Page 4 of 6

services

Student Name Justin B.

School Albemarle High

MEASURABLE POST-SECONDARY GOAL(S) for

Will perform what skill?

My (the student) goal for postsecondary employment is to work

full time in the field of teaching,
mental health services, or law
enforcement.

Year 2015-16

EMPLOYMENT:

At what level?

In what
context?

post-grad reg.
time

How will it be
measured?

full salary,
compena
tion

By what date
or timeframe?

upon
graduatio
n

Assessment used to determine goal: student interview

These are the services and/or coordinated

activities that will help you, the student,
achieve your goal for post-secondary
employment.

Participate in the Work Experience Program,

Participate in role plays, review analyze job
performance descriptions, investige apprenticeship
and participate in volunteer work opportunities.
Participate in CAYIP internship program to develop
work readiness. Woodrow Wilson referral

Person or
Agency
Responsible

Timeline
for
Completion

Dept. of
Rehab
Services

upon
graduatio
n

Completed

Yes:
No:
Comment:

MEASURABLE POST-SECONDARY GOAL(S) for INDEPENDENT LIVING (If Appropriate):

Appropriate (Complete goal below)
Not Appropriate (Not required to complete this
particular Goal)
Will perform what skill?

My (the student) goal for

independent living is to live
independently

At what level?

In what
context?

post-grad daily

How will it be
measured?

By what date
or timeframe?

completi
on of
goal

within
2
years after
graduation

Assessment used to determine goal: student interview

These are the services and/or coordinated

activities that will help you, the student,
achieve your goal for independent living, if
appropriate.

Actively participate in life skills program at Ivy

Creek. Woodrow Wilson referral. Participate in a unit
on household safety. Participate in a course about
living independently. Participate in a course that
covers the basic fundamentals of living
independently.

Form 60.04 ( Revised - 2/2005 ) Page 5 of 6

Person or
Agency
Responsible

Dept. of
Rehab
Services

Timeline
for
Completion

within 2
years of
graduatio
n

Completed

Yes:
No:
Comment:

I have participated in the development of my

transition plan.

Form 60.04 ( Revised - 2/2005 ) Page 6 of 6

Student
Signature:

Date: