Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21
Independent Living Skills
IADL Packet Ages 16–21
Real-looking practice forms and guided reflection questions for the transition years — job applications, credit cards, leases, paychecks, taxes, insurance, and budgeting for independent living.
What's inside — 22 pages
Pages 2–3 — Job Application — Lincoln area employer, full application with employment history and references
Pages 4–5 — Credit Card Application — understanding APR, credit limits, minimum payments, and interest math
Pages 6–7 — Reading a Credit Card Statement — charges, minimum payment, interest if only minimum is paid
Pages 8–9 — Lease Agreement Basics — key terms, tenant rights and responsibilities, what you're agreeing to
Pages 10–11 — Honest Abe's — group dining, splitting a bill, tip on a larger check, paying with a card vs cash
Pages 12–13 — Pay Stub — gross vs net pay, deductions, federal and state tax, understanding your first paycheck
Pages 14–15 — W-4 Tax Form — what it is, how to fill it out, what withholding means
Pages 16–17 — Health Insurance Basics — premiums, deductibles, copays, in vs out of network
Pages 18–19 — Monthly Budget Planning — building a realistic first-apartment budget from a starting salary
Pages 20–21 — Writing a Cover Letter — professional communication for job applications
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Job Application
Real-World Form Practice
Completing a Job Application
Fill out this practice job application completely and neatly. Employers often make hiring decisions based partly on how carefully an application is filled out. Every field matters.
Ideal Grocery — Lincoln, NE
2525 N 27th Street · Lincoln, NE 68521 · Equal Opportunity Employer
Employment Application Please print clearly in blue or black ink
Personal Information
Yes
No
Position & Availability
Full-time
Part-time
Seasonal
Check all days you are available to work:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Education
Yes
No
In Progress
Work Experience — Most Recent First
References — Not Family Members
I certify that all information provided is accurate and complete. I understand that false statements may be grounds for dismissal. I authorize verification of all information provided on this application.
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Job Application
Reflection Questions
Understanding the Job Application
Think carefully about what you filled out
What is a reference and why do employers ask for them? What makes someone a good reference?
The application asks for your 'desired pay.' How would you decide what to write? What is Nebraska's current minimum wage — and is that the only factor to consider?
You certified at the bottom that all information is accurate. Why is honesty on a job application so important — what could happen if you exaggerated?
If you have no work experience yet, what could you write in the work experience section to show you have relevant skills?
Why do most employers ask that references not be family members?
What happens after you apply
Most employers review applications within 1–2 weeks. If selected, you will be called for an interview. If you have not heard back after 1 week, it is appropriate to follow up politely by calling or emailing the store. Saying "I recently submitted an application and wanted to check on its status" shows initiative.
Interview preparation
Know the company — look up what they sell and their values
Dress one step above what employees wear
Arrive 5–10 minutes early — not earlier
Bring a copy of your application and ID
Prepare 2–3 examples of times you showed responsibility, teamwork, or problem-solving
Challenge question
A common interview question is: "Tell me about yourself." Write a 3–4 sentence answer you could give at an interview for this grocery store position. Include who you are, something relevant about your background or skills, and why you want this specific job.
Read this entire practice credit card application before filling anything out. The terms and conditions section is just as important as the application fields — this is the section most people skip and later regret.
Visa Student Card Application For members ages 18+ or 16+ with co-signer
Personal Information
Financial Information
Employment
Self-employed
Other
Yes
No
Key Terms & Rates — Read Before Signing
Annual Percentage Rate (APR) — Purchases
22.99% variable
APR — Cash Advances
27.99% — higher than purchases
Annual Fee
$0 (no annual fee for student card)
Minimum Credit Limit
$300
Maximum Credit Limit (first year)
$1,000
Minimum Monthly Payment
$25 or 2% of balance, whichever is greater
Late Payment Fee
Up to $29
Grace Period
25 days — no interest if paid in full each month
Foreign Transaction Fee
3% of each transaction
By signing below, I confirm that all information is accurate, I have read and agree to the Cardholder Agreement, and I understand this application will result in a credit inquiry that may affect my credit score.
Use the application on the previous page to answer these
What is APR? The card shows 22.99% APR for purchases. In plain language, what does this mean for you if you don't pay your full balance each month?
The card has a grace period of 25 days. What does this mean — and what do you need to do to take advantage of it and pay zero interest?
If your balance is $500 and you only make the minimum payment of $25 this month, roughly how long would it take to pay off and how much interest would you pay? (Estimate — exact math not required.)
The application asks for your Social Security Number. Why does a credit card company need this?
What does it mean that this application will result in a 'credit inquiry that may affect your credit score'? What is a credit score?
Interest math — the real cost of a credit card
If you spend $800 on a credit card at 22.99% APR and only make minimum payments:
You'd be paying for approximately 4–5 years
You'd pay roughly $400–500 in interest on top of the $800
The $800 purchase actually costs you ~$1,300
Credit cards are not free money. They are a loan — and loans cost money.
Building good credit — what it means
A credit score (300–850) tells lenders how reliably you pay debts. A high score means:
Lower interest rates on loans
Easier to rent an apartment
Sometimes required for jobs
How to build it: Pay on time every month. Keep your balance below 30% of your limit. Don't open too many accounts at once.
Interest calculation practice
Your credit card balance is $350. The APR is 22.99%. To find the monthly interest charge: divide the APR by 12 months, then multiply by your balance.
Interest Charge Information: If you pay the New Balance in full by July 18, 2025, no interest will be charged. If you pay only the minimum, the estimated interest charge next month will be $5.99. If you make no payment, a late fee of up to $29 will be added and your APR may increase.
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Credit Card Statement
Reflection Questions
Understanding the Statement
Use the statement on the previous page to answer these
Morgan paid the full previous balance of $124.50. Why is paying the full balance each month — rather than just the minimum — the smartest financial choice?
Morgan's credit limit is $500 and the new balance is $312.47. What percentage of the credit limit is being used? (Divide balance by limit × 100.) Financial experts suggest keeping this below 30% — is Morgan within that range?
Looking at the charges, which expenses were needs (essential) vs wants (optional)? List at least 2 of each.
Morgan has two monthly subscription charges totalling $25.48. These recur every month automatically. What is the risk of forgetting about recurring charges on a credit card?
If Morgan can only pay $100 toward the balance this month, how much interest will accrue on the remaining balance? (Use the $5.99 estimate per $312.47 to estimate proportionally.)
Budget analysis — categorise Morgan's spending
Look at all June charges and group them into these categories. Calculate the total for each:
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Lease Agreement
Real-World Form Practice
Understanding a Residential Lease Agreement
A lease is a legally binding contract. Before you sign one, you must understand every section. Read this practice lease summary carefully — it covers the key terms you will find in any real lease.
Haymarket Property Management — Lincoln, NE
221 N 9th Street · Lincoln, NE 68508 · (402) 555-0181
Residential Lease Agreement Unit 2B · 1440 Q Street, Lincoln NE 68508
Parties to This Agreement
Haymarket Property Management
Lease Terms
August 1, 2025
July 31, 2026
$875.00
1st of each month
$875.00 (1 month)
$50 flat fee + $10/day
60 days written notice
Utilities & What's Included
Included in rent:
Water and sewer
Trash removal
Lawn maintenance
Parking (1 space)
Tenant pays separately:
Electric (Lincoln Electric System)
Gas (Black Hills Energy)
Internet / cable
Renter's insurance (required)
Tenant Responsibilities & Rules
• Keep the unit clean and in good condition
• Report maintenance issues within 48 hours
• No smoking inside the unit or within 25 feet of the building
• Pets require a separate Pet Addendum and $300 non-refundable fee
• Tenant is responsible for their guests' behaviour
• No alterations to the unit without written permission
Security Deposit — Return Conditions
The security deposit of $875 will be returned within 14 days of move-out, less deductions for: unpaid rent, damage beyond normal wear and tear, professional cleaning required, or lease violations. Tenant must provide a forwarding address in writing.
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Lease Agreement
Reflection Questions
Understanding the Lease
Read every question carefully before answering
You move in on August 1. What is the total amount you need to have on Day 1 before you can get the keys? (Hint: it's more than just first month's rent.)
You want a dog. Looking at the lease, what would you need to do — and what would it cost — to have a pet in this apartment?
Your rent is due on the 1st. You pay on the 7th. How much is your late fee for that month?
You decide to move out. What do you need to do and when — and what happens if you just leave without notice?
The lease requires renter's insurance. What is renter's insurance and why do landlords require it? (You may not know — write your best guess, then ask your OT or look it up.)
True cost of this apartment per month
Rent is just the beginning. Estimate the full monthly cost:
$875.00
Things to check before signing any lease
Walk through the unit and document any existing damage in writing before move-in
Confirm exactly what utilities are included
Read the full lease - not just the summary
Ask about the move-out inspection process
Understand the break-lease penalty if you need to leave early
Never sign a lease for a unit you have not personally viewed
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Restaurant & Paying
Math & Decision Making
Group Dining Scenarios
Scenario 1 — Five friends, separate orders
Each person orders: one Classic Burger ($12.95), Freedom Fries ($3.50), and a fountain drink ($2.50). You are splitting the bill with separate payments but one check. Calculate each person's share including 7% tax and an 18% tip on the pre-tax total.
Scenario 2 — Paying with a card vs cash
Your total bill (including tax and 18% tip) is $108.72. You can pay with a debit card or with cash. You have $120 in cash. Calculate:
Scenario 3 — One friend can't pay their share
Your group's total bill is $108.72 split 5 ways = $21.74 each. One friend forgot their wallet. The other four friends need to cover their share. How much does each of the four paying friends now owe?
Real-world reflection
What is the social norm around tipping at a sit-down restaurant? How is this different from a fast food counter?
You are paying on a credit card for the whole table to earn rewards points. Your friends pay you back in cash. What is the risk of this arrangement?
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Pay Stub
Real-World Form Practice
Understanding Your First Pay Stub
A pay stub is the document that comes with your paycheck explaining exactly how your gross pay became your net pay. Most people are surprised by how much smaller net pay is than expected. Read every line.
Ideal Grocery — Lincoln, NE
2525 N 27th Street · Lincoln, NE 68521 · EIN: 47-1234567
Employee: Jordan A. Martinez
SSN: ***-**-1234 · Employee ID: 00482
Pay Period: June 1–15, 2025
Earnings This Period
Type
Hours
Rate
Amount
Regular
32.00
$13.50
$432.00
Overtime
0.00
$20.25
$0.00
GROSS PAY
$432.00
Deductions This Period
Deduction
Amount
Federal Income Tax (W-4: Single, 0 allowances)
-$43.20
Nebraska State Income Tax
-$19.44
Social Security Tax (6.2%)
-$26.78
Medicare Tax (1.45%)
-$6.26
TOTAL DEDUCTIONS
-$95.68
Gross Pay This Period
$432.00
Total Deductions
-$95.68
NET PAY
$336.32
YTD Gross Pay
$2,808.00
Pay Date: June 20, 2025 · Pay Method: Direct Deposit to account ending ****4821 · YTD Deductions: $621.92 · Questions about your pay? Contact HR at (402) 555-0200
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Pay Stub
Reflection Questions
Understanding Your Paycheck
Use the pay stub on the previous page to answer these
What is the difference between gross pay and net pay? Which one actually goes into your bank account?
Four different taxes are deducted. Name them and explain what each one pays for. (You may need to research Social Security and Medicare.)
Jordan earns $13.50 per hour. At the end of the month (two pay periods), how much gross pay does Jordan earn? How much does Jordan actually take home after deductions?
Jordan works 32 hours per week. What is the maximum number of hours Jordan could work in a two-week pay period before earning overtime? What does overtime pay mean?
What does YTD mean? Using the YTD Gross Pay of $2,808.00 and the current period gross of $432.00, approximately how many pay periods has Jordan worked?
The taxes on your paycheck explained
Federal Income Tax — goes to the US federal government; funds national programs
State Income Tax — goes to Nebraska; funds state roads, schools, services
Social Security (6.2%) — retirement fund; you may draw from this when you retire at ~67
Medicare (1.45%) — healthcare for Americans 65+; you will use this when you are older
Your employer also pays an equal amount of Social Security and Medicare — you only see your half.
Monthly income planning
Based on this pay stub, Jordan's monthly net income (2 pay periods) is approximately $672.64. Use this to estimate how Jordan could budget:
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · W-4 Tax Form
Real-World Form Practice
Completing a W-4 — Employee's Withholding Certificate
The W-4 is the form you fill out when you start a new job. It tells your employer how much federal income tax to withhold from each paycheck. Filling it out incorrectly means you may owe a large tax bill in April — or get a smaller paycheck than necessary.
Form W-4 (2025)
Employee's Withholding Certificate · Department of the Treasury · Internal Revenue Service
Complete and give to your employer Your employer keeps this — you get a copy
What this form does: Your employer uses the information here to calculate how much federal income tax to take out of each paycheck. If too little is withheld, you will owe money in April. If too much is withheld, the government sends you a tax refund. Most people aim to break even.
Step 1 — Personal Information (Required)
Single or Married Filing Separately
Married Filing Jointly
Head of Household
Step 2 — Multiple Jobs or Spouse Works
Complete this step ONLY if you hold more than one job at a time, or if you are married filing jointly and your spouse also works. Most first-time workers leave this step blank.
I have more than one job (or spouse works) — I have completed the worksheet on the back
Step 3 — Claim Dependents
A dependent is someone you financially support — typically a child under 17 or another qualifying person. Most students and first-time workers have no dependents. Leave blank if this does not apply.
Step 4 — Other Adjustments (Optional)
Step 5 — Sign Here (Required)
Under penalty of perjury, I declare that this certificate, to the best of my knowledge and belief, is true, correct, and complete.
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Health Insurance
Real-World Knowledge
Understanding Health Insurance
Health insurance is one of the most important and confusing financial products adults manage. Understanding the key terms before you need to use your insurance prevents expensive surprises.
Key Health Insurance Terms
Premium
The monthly amount you pay for insurance — regardless of whether you use it. Like a subscription fee for having coverage.
Deductible
The amount you must pay OUT OF POCKET before insurance starts paying. If your deductible is $1,000 — you pay the first $1,000 of medical bills each year.
Copay
A flat fee you pay each time you visit a doctor (e.g. $30 per visit). Copays often apply even before your deductible is met.
Coinsurance
After your deductible is met, you and insurance share costs. An 80/20 plan means insurance pays 80%, you pay 20%.
Out-of-Pocket Maximum
The most you will EVER pay in a year. After you hit this number, insurance covers 100% of everything.
In-Network vs Out-of-Network
In-network doctors have agreements with your insurance — much cheaper. Out-of-network means you pay significantly more or everything.
Explanation of Benefits (EOB)
A document your insurance sends after a medical visit explaining what was billed, what insurance paid, and what you owe.
Practice Insurance Plan — Great Plains Health
Monthly Premium
$187.00
Annual Deductible
$1,500 individual
Copay — Primary Care
$25 per visit
Copay — Specialist
$50 per visit
Copay — Emergency Room
$150 per visit
Coinsurance (after deductible)
80% insurance / 20% you
Out-of-Pocket Maximum
$5,000 per year
Prescription Drug Copay
$10 generic / $40 brand-name
When can you stay on a parent's plan?
Under the Affordable Care Act, you can stay on a parent's health insurance plan until age 26 — even if you are married, not living at home, or not financially dependent on them. This is often the cheapest option for young adults.
After 26, you must find your own coverage through an employer, the Healthcare Marketplace (healthcare.gov), Medicaid, or CHIP if eligible.
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Health Insurance
Reflection & Math Practice
Using the Insurance Plan
Use the Great Plains Health plan from the previous page
You visit your primary care doctor for a checkup. You have not yet met your deductible. How much do you pay at this visit?
You break your arm and go to the emergency room. Your total bill is $3,200. You have already met your $1,500 deductible this year. How much do you owe? (Remember: 20% coinsurance applies after the deductible.)
What is the maximum you could possibly pay in one year under this plan, including your monthly premiums? (Out-of-pocket max + 12 months of premiums.)
Your doctor recommends a specialist. You look up the specialist and discover they are out-of-network. What does this mean for your costs — and what should you do?
A friend says 'I'm young and healthy — I don't need health insurance.' What would you say in response?
Scenario math — a complicated medical year
In one year, Morgan has the following medical expenses (before insurance): 3 primary care visits, 1 ER visit, and a surgery billed at $8,000. The deductible is $1,500 and coinsurance is 80/20.
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Monthly Budget
Real-World Skills
Building Your First Monthly Budget
You have just started a full-time job in Lincoln earning $15.00 per hour, 40 hours per week. Use the 50/30/20 budgeting rule to plan your monthly spending. Remember: budget from your net pay, not your gross pay.
The 50/30/20 Rule
50%
Needs Rent, food, transportation, utilities, insurance — things you must pay
30%
Wants Dining out, entertainment, subscriptions, shopping — things you choose to spend on
20%
Savings Emergency fund, retirement, savings goals, extra debt payments
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Monthly Budget
Reflection Questions
Thinking About Your Budget
Based on the budget you built on the previous page
Did your needs fit within 50% of your net income? If not, what would you adjust first — and what is non-negotiable?
What is an emergency fund and why do financial experts say it should be the first savings goal? How many months of expenses is recommended?
You earn $15/hour but your friend earns $22/hour at a different job. Does that mean your friend takes home $7 more per hour? Explain.
If you put $200 per month into a savings account earning 4.5% annual interest, approximately how much would you have after 2 years? (Estimate: $200 × 24 months = base, then add rough interest.)
Looking at your budget — what is the single most impactful change you could make to either save more money or reduce financial stress?
Financial goals — short, medium, and long term
Write one realistic financial goal for each timeframe:
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Cover Letter
Professional Communication
Writing a Cover Letter
A cover letter accompanies a job application and introduces you in your own words. Unlike a resume, it lets you explain why you want this specific job and what you bring beyond what is on the application form. Many employers read cover letters first.
Cover letter structure
1. Your contact information
Name, address, phone, email — at the top
2. Date
Today's date
3. Employer's information
Company name, address, hiring manager name if known
4. Salutation
'Dear Hiring Manager:' if you don't know the name
5. Opening paragraph
State the job you're applying for and one strong reason you're a good fit
6. Body paragraph
1–2 specific examples of your skills, experiences, or qualities relevant to the job
7. Closing paragraph
Thank them, state you'd welcome an interview, mention how to reach you
8. Sign-off
'Sincerely,' then your name
Cover letter do's
Keep it to one page — always
Address the specific job and company
Use specific examples not vague claims ("I once helped a customer find a product when the system was down" beats "I have good customer service skills")
Proofread twice — one typo can cost you an interview
Match the tone of the company
Cover letter don'ts
Don't start with "My name is..." — they can see your name at the top
Don't repeat your resume word for word
Don't say "To Whom It May Concern" if you can find the name
Don't mention salary expectations unless asked
Don't use slang or casual language
Sample cover letter — read this, then write your own on the next page using the job application from pages 2–3.
Jordan Martinez · 1842 Vine Street · Lincoln, NE 68508 · (402) 555-7821 · jordan.martinez@email.com
June 27, 2025
Hiring Manager Ideal Grocery 2525 N 27th Street · Lincoln, NE 68521
Dear Hiring Manager,
I am writing to apply for the part-time grocery associate position at Ideal Grocery. I am a motivated 17-year-old Lincoln resident currently attending Lincoln High School, and I am looking for my first formal work experience in a customer-facing environment.
This past year I volunteered at the Lincoln Food Bank every Saturday for six months, where I sorted donations, assisted elderly visitors with their selections, and maintained a clean and organised storage area. This experience taught me the importance of attention to detail, working efficiently as part of a team, and treating every visitor with patience and respect — qualities I believe are directly relevant to working in a grocery store.
I am available Monday through Friday after 3:00 PM and all day on weekends. I am a reliable and punctual person — in six months of volunteering I was never late or absent. I would welcome the opportunity to bring that same commitment to the Ideal Grocery team.
Thank you for considering my application. I would be glad to come in for an interview at your convenience and can be reached by phone or email at the contact information above.
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Cover Letter
Practice Activity
Write Your Own Cover Letter
Using the structure and sample from the previous page, write a cover letter for the Ideal Grocery job application you completed on pages 2–3. Use your own real or realistic information.
Inspire Skill Builders by Inspire Pediatric Therapy
IADL Packet · Ages 16–21 · Clinician Reference
For the OT
Clinician Reference — Ages 16–21 IADL Packet
Goal bank
Sample Goals
STG — Job Application
Student will independently complete a multi-section job application form including employment history and references with accurate, legible information and no required fields left blank, in 3 of 4 trials with no more than 1 verbal prompt.
STG — Financial Documents
Student will read a pay stub and accurately identify gross pay, net pay, and two tax deductions, explaining what each represents, with no more than 1 verbal cue, in 3 of 4 opportunities.
STG — Credit Literacy
Student will read a credit card statement and correctly identify the minimum payment, balance, due date, and the financial consequence of paying only the minimum, in 3 of 4 trials.
STG — Lease Understanding
Student will review a residential lease agreement and accurately identify rent due date, late fee structure, security deposit requirements, and tenant responsibilities, in 3 of 4 opportunities.
LTG — Independent Financial Participation
Student will independently complete a monthly budget using actual income and expense data, demonstrating spending within income limits and identification of at least one savings goal, with no adult support, in 3 of 4 observed opportunities.
Grading — grade down
Pre-fill non-critical fields to reduce reading demand
Provide a vocabulary list for financial terms
Allow calculator for all math sections
Do forms verbally before written completion
Use a real parent's pay stub (with permission) instead of the practice version
Grading — grade up
Complete a real job application for an actual Lincoln employer
Role-play a job interview using the application and cover letter
Build a budget from student's actual current income and expenses
Visit a real apartment listing and evaluate affordability
Use a real credit card statement from a family member (with permission)
Coaching notes — what to emphasise at this age
Students 16–21 are at the cusp of real financial decision-making. The most important shifts to support are: understanding that gross ≠ net, that credit is a loan with a cost, that a lease is a legal commitment, and that a budget is not a restriction but a tool for freedom. Many students in this age group have had no formal exposure to any of these concepts. Normalise not knowing — the goal is building the vocabulary and confidence to ask the right questions of real-world institutions.
Inspire Pediatric Therapy
Lincoln & Omaha, Nebraska · inspirepeds.org · 402-413-7999
These resources are for educational and therapeutic use. They do not constitute financial, legal, or tax advice.
