Needs assessment

Organization name(Required)

Please tell us about your organization. What do you do? Who do you provide service to?(Required)

Please describe the team that will be taking part in this program/event. Where do they fit in your organization?

Please select your top three objectives from this list:

Leadership development

Team development

Personal development

Creating "big picture" thinking and generating interdepartmental collaboration

Deepening a sense of responsibility, empowerment, and ownership

Challenging unproductive and limiting mindsets

Creating an environment that allows team members to get to know one another better

Developing effective problem-solving and decision-making skills

Learning to thrive in a constantly changing environment

Avoiding unwarranted conflict while learning to benefit from healthy opposition

Fostering effective communication

What are things you feel are important for our facilitators to know about this group?

How interactive would you like the program to be?

Would you like an in-person or virtual session?

In-person

Virtual

What is the highest value of your program?

Learning

Fun

What might we do that would make you *unhappy* with our service?

Number of participants(Required)

Age range

Gender balance

Special requirements

Program date

YYYY slash MM slash DD

Program times

Program location

Your name

First Last

Email

Phone

Role or title

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