A GUIDE TO WRITING YOUR LIFE STORY. Identifying information: Name and maiden name, date and place of birth:

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1 1 A GUIDE TO WRITING YOUR LIFE STORY You are welcome to answer the following questions here or write your own essay on separate paper. If you would like to complete this on your computer ask your trainer to send it via . Please cover the following topics: Identifying information: and maiden name, date and place of birth: Education: a. Describe your school years including the highest grade completed and your feelings about your school experiences. Occupation: A. Where are you currently employed and what is your position? B. What are your work hours? C. Describe your work responsibilities; what about your work is important to you? D. List the jobs you have had in the last five years. Family Background Information: Father s name Occupation. Age. Where does he reside?. If no longer living, year of death. Mother s name Occupation. Age. Where does she reside?. If no longer living, year of death.

2 2 Siblings (Sisters and brothers) NAME AGE MARITAL # OF CHILDREN OCCUPATION RESIDENCE STATUS Childhood and Family Life: A. Describe your parents and your childhood relationship with them. B. How was discipline handled in your home? C. How was affection shown; did you feel supported? D. Describe the atmosphere in your childhood home; did you feel safe, loved, nurtured? If not, what was your experience and what problems did your family encounter? E. Was religion an important part of your childhood? If so, how did it fit into your family life? F. Describe your childhood relationship with your siblings.

3 3 MY FAMILY HISTORY (To be completed by the prospective foster/adoptive parent) of person completing this section: 1. Who were all the people who lived with you (birth date and relationship) when you were between the ages of: A. through five years old: B. six through eleven, if different: C. Twelve through fifteen, if different: D. Sixteen until you left home, if different: Current family associations:

4 A. Describe you current relationship with your parents and siblings including frequency of contact and the quality of your relationships. 4 B. Describe the values and traditions that are important to you and your family or origin. Marriage or Union: A. Describe how and when you and your partner met. B. What attracted you to your partner? C. Have you been together continuously since you met? Have you experienced any separations? D. of Marriage or Union. E. Describe your relationship including any strengths or weaknesses in your marriage or union. F. Describe your partner as an individual. G. How are important decisions made in your family and how do you handle disagreements? Previous Marriage or Union:

5 5 A. Is this your first marriage or partnership? B. Describe any previous marital relationship and the reasons the relationship ended. Children: A. List the children in your family including their name, age, grade, and the school they attend. B. Describe each child s personality. C. In what ways are your ideas about raising children similar or dissimilar from your parents? D. Do you and your partner agree on issues of child rearing or are there areas of conflict? E. What are your methods of discipline? F. What are your expectations of children?

6 6 Hobbies and interests. Briefly describe what your hobbies and interests consist of and if they are shared with other family members. Conclusion/Evaluation: A. What personal strengths and background do you have that will enable you to parent children with special needs? B. What behaviors in a child would you find most difficult to work with and why? C. Adding a new child to your family will mean changes in your present way of life. What do you think will be the major changes and how will you handle these?

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