REQUEST A PROPOSAL

Contact Information

School/Organization:
Grade (s):
Contact Information:
Telephone:
Email:
Address:
City:
State / Zip:

Request Overview

Please provide a brief overview of the program you envision including current issues that you would like to address, goals you have for the program and other types of programs in which you have participated:

Requested Dates:

First Choice:
Second Choice:
Estimated Program Budget:
Program Type
DayOvernight

Student Program Objectives (Check as many as apply)

Orientation
Moving Up/Capstone Event
Team Building
Conflict Resolution
Bullying Workshop
Personal Skills Development
Clique Busting
Environmental/Nature Study
Leadership Development
Bonding
Trust Workshop
Other (Describe Below)

Staff Development Program Objectives (Check as many as apply)

Team Building
Tone Setting
Resource Management
Effective Feedback
Bullying Workshop
Exploring Diversity
Leadership
Problem Solving Skills
Conflict Resolution
Achieving Group Consensus
Experiential Ed. Workshop
Coordination
Play/Fun/Spirit Building
Decision Making
Group Focus
Team Spirit
Cooperation
Peer respect

Program Elements or Interest (Check as many as apply)

Ice Breakers
Marine Study
Field Games and Initiatives
Outdoor Skills Development
Hiking
Caving
Camping
Rock Climbing
Sailing
High Ropes
Canoeing
Low Ropes
Nature Study
Adventure Race
Other (Explain)

Please use the space below to provide any additional information that might help us provide a specific program proposal: