ALS RPL Form 1

DOCUMENTATION OF LIFE EXPERIENCES

(A) Experiences with equipment
(1) Personal Information __________________________________________________
__________________________________________________
Name:___________________ Community Learning Center___________ __________________________________________________
__________________________________________________
Address: ____________________________________________________
(B) Experiences with money
Tell me about your family and where you live __________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________
(C) Experiences with food
(2) Experiences __________________________________________________
Use the examples to help you remember experiences you had. __________________________________________________
Experiences can be in __________________________________________________
 Paid work __________________________________________________
 Unpaid work
 Voluntary activities (D) Experiences with the Environment
 The home
__________________________________________________
 Your family
__________________________________________________
__________________________________________________
__________________________________________________

(E) Experiences with materials

 (B) Experiences with money ALS RPL Form 1
__________________________________________________
__________________________________________________
DOCUMENTATION OF LIFE EXPERIENCES
__________________________________________________

(1) Personal Information (C) Experiences with food

__________________________________________________
Name:___________________ Community Learning Center___________ __________________________________________________
__________________________________________________
Address: ____________________________________________________ __________________________________________________
Tell me about your family and where you live __________________
(D) Experiences with the Environment
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________

(2) Experiences (E) Experiences with materials

Use the examples to help you remember experiences you had. __________________________________________________
Experiences can be in
__________________________________________________
 Paid work
 Unpaid work __________________________________________________
 Voluntary activities __________________________________________________
 The home (F) Experience with art
 Your family __________________________________________________
____________________________ __________________________________________________
(A) Experiences with equipment __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
(G) Experiences with people ALS RPL Form 1
__________________________________________________
__________________________________________________
 I think I am good at ________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
(H) Experiences with information __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________ (4) About me

(I) Experiences with community activities  The best thing about me is _________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
(3) Interest and Hobbies
 I like doing ___________________________________________  When I finish my study I want to: ____________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________
__________________________________________________ __________________________________________________

Learner________________ Instructional Manager__________________

Date_____________________ Date ____________________________