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L.E.A.D. PROGRAM Intake Form
Thank you for your interest in Normandale Community College's L.E.A.D. Program supported by Student Life. We look forward to working with your group on this interactive and educational experience. Please complete the following form to assist our team in developing a program specifically catered to your unique group. Completed forms should be submitted at least one week prior to your scheduled program date.
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* Indicates required question
Group/Class Name:
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Your answer
Group Contact/Organizer:
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Your answer
Group Contact Phone #:
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Your answer
Group Contact Email:
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Your answer
Date of Event:
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MM
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DD
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YYYY
Room #/Location:
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Your answer
Start Time:
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Time
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AM
PM
End Time:
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Time
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AM
PM
# of Participants:
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Your answer
Special Needs/Request/Accommodations:
Your answer
Please select any core competencies you would like emphasized:
Accepting Personal Responsibility
Discovering Self/Group Motivation
Mastering Self/Group Management
Employing Interdependence
Gaining Self-Awareness
Adopting Lifelong Learning
Developing Emotional Intelligence
Understanding Individual vs. Group Goals
Enhancing Small Group Communication
The first seven core competencies align with content from "On Course: Strategies for Creating Success in College and in Life".
Expectations of this experience and desired outcomes:
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Your answer
Any other information the facilitators should know (Skills to be addressed, characteristics of your group, familiarity of your group, etc.):
Your answer
** Please make sure participants come dressed for activity and movement!**
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