TRANSITION ASSISTANCE INITIAL SELF-ASSESSMENT WORKSHEETSECTION A. SERVICE MEMBER INFORMATIONNAME:

DOD ID:INSTALLATION:WORK EMAIL:PERSONAL EMAIL:

DATE OF SEPARATION:WORK PHONE:

HOW MANY YEARS OF SERVICE:

CELL PHONE:

DOB:

AGE:

GENDER:SECTION B. DEMOGRAPHICS

Rank:

E1-E5

Service Branch:

E6-E7USN

E8-E9
USAF

O1-O3USA

O4-O6

USMC

O7-O10WO1-CWO5USCG

Reserve

Guard

Rate/Designator/MOS/AFSC:
Marital Status:

SingleHighest Level of Education:

MarriedGED/HS

WidowedAssociates

Divorced
Bachelors

SeparatedMasters

Children#Post-Graduate

Doctorate

Concentration:

SECTION C. DISCHARGE
Retiring 20+ Years
Medical Retirement
Medical Separation
Voluntary Separation
Involuntary Separation
Administrative Separation
Demobilization

Yes
Yes
Yes
Yes
Yes
Yes
Yes

No
No
No
No
No
No
No

SECTION D. PROJECTED CHARACTERIZATION OF DISCHARGE
Honorable
Honorable Conditions (General)
Other than Honorable
Bad Conduct
Dishonorable
Dismissed
Uncharacterized
Unknown

Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes

No
No
No
No
No
No
No
No

SECTION E. PERSONAL GOALS
What are your post-separation short-term goals?

What are your post-separation long-term goals?

2019

SECTION F. FACTORSFAMILY LIFE AND RELOCATION PLAN:
1. Do you plan to relocate after leaving the military?

Yes

NoUnsure

Yes
Yes

NoNoUnsure

4. Does the thought of leaving the military create stress on you or your family?

Yes

NoFINANCIAL PLAN:
1. Have you initiated projected post transition budget?
2. Are you planning for your retirement? (e.g. TSP, 401K)
3. Have you established a financial emergency plan?
4. Do you have adequate cash set aside in case of emergencies?
5. Have you considered additional expenses? (childcare or child support, commuting, etc.)
6. Have you calculated the impact of renting vs. buying during your transition period?
7. Have you examined your tax status with regard to taxable income?
8. Have you reviewed your vehicle(s) payment, insurance, registration and taxes?
9. Have you assessed your insurance needs? (medical, exceptional family member, dental, life)
10. Have you reviewed your credit report in the last 4 months?
11. Do you have an up-to-date will and/or power of attorney?

YesYes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes

No
No
No
No
No
No
No
No
No
No
No

EMPLOYMENT PLAN
1. Do you plan to work after leaving the military?
2. Do you have a confirmed job offer?
3. Do you have an updated resume?
4. Do you plan on staying in your current career field?
5. Would you like more information on employment?

Yes
Yes
Yes
Yes
Yes

No
No
No
No
No

EDUCATION PLAN
1. Do you plan to enroll in continuing education or do you have enrollment confirmation?
2. Do you have a professional license(s)/certificate(s)?
3. Would you like more information on education?

Yes
Yes
Yes

NoNo
No

ENTREPRENEURSHIP PLAN
1. Do you currently own a business?
2. Do you intend to start your own business after leaving the military?
3. Do you have a business plan?
4. Would you like more information on entrepreneurship?

Yes
Yes
Yes
Yes

NoNo
NoNo

VOCATIONAL PLAN
1. Have you attended a trade school?
2. Are you enrolled in or plan to enroll in an apprenticeship program?
3. Do you have a technical or trade license(s)/certification(s)?
4. Would you like more information on trades?

Yes
Yes
Yes
Yes

NoNoNoNo

If Yes, where?
2. Is cost of living higher where you plan to relocate?
3. Do you anticipate having a support system in place?
e.g., Family, Friends, Mentor, Transportation, Housing

N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A

SECTION G. TRACKS2019

TAP Service Member Information

How did you find out about TAP requirements?
Have you previously attended a TAP workshop?

Yes

No

** If yes, please provide dates and location:
Do you have a disability that may impact your pursuit in a job or school?
YesNoPendingExplain:
I have ________ to support my current lifestyle after I transition
No Funds
Limited Funds
Adequate Funds
Explain:
How interested are you in TAP Assistance?
Not Interested
Interested

Very Interested

Explain:My civilian career path _____ to my AFSC
Does not alignSlightly aligns
AlignsI am seeking a ____ demand career field. O*NET Resources : www.mynextmove.org
Low
ModerateHighExplain:
I have already secured post-transition employment (have job offer)
YesNoExplain:
Are you planning on continuing your education?
Not currently applying
Currently applying

Secured school

Explain:(Employment/Vocational/Education/Entreprenuership)

I am ______ in attending one of the two day tracks
Interested

Slightly Interested

Very Interested

Explain:
I am ______ with my decision to transition
Uncomfortable
Somewhat comfortable

Very comfortable

Explain:I feel that I have ______ network of friends/co-workers/famly as I transition
No Support

Some Support

I would like to sign up for the following week of TAP:

Good Support
Option 1
Option 2

I am interested in the two day track for: None
Requested date for track:

None