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Personal Summary

There are two options for completing this page.  You can print out this page and fill out the personal summary by hand or you can fill it out on-line and print out the page when you are done. Present the information in the "Self Advocacy" section to the college service provider along with your documentation to receive accommodations at college.

 

Pre-Assessment Personal View

Name:   

Social Security Number: 

Career goal: 

Educational goal: 

Self-rating
Rate yourself on the following on a scale of 1 to 4. Mark the correct response.
(1=I cannot do by myself, 2=I require a great deal of help, 3=I require a little help, 4=I can do by myself.)

Time Management/Organization Independence Skills
Self-responsibility 1 2 3 4 Money Management 1 2 3 4

Organization

1 2 3 4 Meet personal needs 1 2 3 4
Study skills 1 2 3 4 Care for health needs
(Medication) 		1 2 3 4


Self-advocacy

My disability as defined in my documentation is  

I learn best when 

Date of documentation:  

Source of documentation:

I have received special education services because:

Accommodations specified in documentation:

Note: Accommodations must be specified in your documentation to support requests for services at college.

In school, this affects my ability to:

In outside activities/work, this affects my ability to:

Accommodations (modifications/support) I plan to ask for in college include:


Please review your own documentation and complete the following:

Accommodations I use not specified in documentation:

Plan to update documentation to include support for accommodations listed above:

 

 

 

 

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