Post Program Report

Facilitator Name*

Email*

FacID*

Program Date*

Client*

ProgID*

Number of Participants

Actual agenda/timeline and specific activities presented*

Observations (bullet points: Include overall program and team dynamics as well as reflections from each activity)

OPTIONAL Attachment: Upload additional supporting document (e.g., in case of formatted texted or more detailed report to share with client):

How did you find out about AAI?

Web SearchColleague Referred MeAEEWorked with AAI BeforeOther

Facilitation Experience

Please check the most accurate description of your skills and experience with each of the following.
Ctrl + click to select multiple

I have facilitated youth/camp programsI have co-facilitated adult groupsI have facilitated adult groupsI have facilitated corporate teams

MBTI

I don't know what the letters stand forI know my type preference and am familiar with the conceptsI have co-facilitated or assisted with an MBTI training workshopI am qualified and have administered MBTI in a corporate setting

DiSC

I don't know what the letters stand forI know what my profile is and am familiar with the conceptsI have co-facilitated or assisted with a DiSC training workshopI am qualified and have administered DiSC in a corporate setting

Sailing

Forget it. I get seasick taking a bathI am familiar with sailing recreationallyI have co-facilitated or assisted with a team building sailing programI have been the lead facilitator for a corporate sailing workshop

Orienteering

That's with a map and compass, right?I am very skilled getting around with a map and compassI have co-facilitated or assisted with a team orienteering programI have been the lead facilitator for a corporate workshop that implemented orienteering

GPS

Global positioning station, right?I have used a handheld GPS deviceI have co-facilitated or assisted with a team building GPS programI have been the lead facilitator for a corporate GPS workshop

Indoor Rock Climbing

Never did itI am an experienced rock climberI have co-facilitated or assisted with a team building rock-climbing programI have been the lead facilitator for a corporate rock-climbing workshop

Ropes Course

I know what it isI have participated in low and high ropes course elementsI have co-facilitated or assisted with a team building ropes course programI have been the lead facilitator for a corporate ropes course workshop

Logistics

Hate itI have organized personal adventuresI have assisted with the logistics for large group eventsI have been the lead logistics coordinator/facilitator for a corporate event

I am a US Coast Guard certified sailing instructor.

YesNo

I can set a temporary orienteering course.

YesNo

I can set a GPS course.

YesNo

My Standard First Aid/CPR training is current.

YesNo

My Standard First Aid/CPR training expires (mm/dd/yy):

I am EMT trained and my training is current.

YesNo

Please list your affiliations with professional and/or recreational affiliations, associations and training certifications (for example, AEE, ASTD, etc.)