North Carolina Outward Bound Schools: Schools & Groups
Schools & Groups

Program Design Questionnaire

 
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We design our group education programs by:
Understanding the context, objectives and demographics of your group
Establishing the logistical parameters for your group

By completing the following questionnaire, you will give us much of the information we need to design a high quality program that meets your needs and parameters
Contact Information
* - indicates required information
School/Youth Group/College:
 *
Name:
 *
Title/Position:
Address 1:
Address 2:
City:
State:
Zip Code:
Day Telephone Number:
Evening Telephone Number:
Cell Phone Number:
Fax Number:
Email:
 *
(ex:johnsmith@abcd.com)
Web Address:
Your Group
Number of participants:
Ages:
Gender Mix:
 % Female      % Male
Physical Fitness Level:
 Low Average High Varied
Other Useful Information (e.g. leadership abilities, previous experience of participants, socio-economics, racial or ethnic diversity, religion, disabilities):
Your Objectives
Outward Bound programs are designed to help people to discover and develop their potential to care for themselves, others and the world around them. We design courses to ensure we are preparing people to address the challenges they face in their lives and communities. Please give us some information so we understand your group:
Narrative – Please describe in detail the challenges that you hope Outward Bound will help your group address. (e.g. My students will soon be transitioning to High School where they will struggle with peer pressure, defining their identity, organizational skills and maintaining community.)
Outcomes – Please check any specific outcomes with which you want your participants to leave.
Compassion
Self-confidence
Physical Fitness
Craftsmanship
Service Ethic
Values Clarification
Moral Courage
Environmental Awareness
Diversity and Social Justice Awareness
Leadership Skills
Teamwork Skills
Problem-solving Skills
Community Building
Conflict Resolution or Peer Mediation Skills
Technical Outdoor Skills
Training for Outdoor Leaders
Training for Educators
Other
Your Logistical Parameters
Time of year or specific
dates that you would like
your group to attend:
Number of program days:
Location and Activity – Check all locations you are interested in programming.
(Please notice dates that programming is possible for each area.)
  North Carolina Mountains
(All Year)		 Florida Ten Thousand Islands
(Nov–Mar)		 North Carolina Outer Banks
(May–Sep)		 Patagonia
(Dec–May)		 Bahamas
(Dec–Jun)		 Your Community
(All Year)
 
Check any specific activities you wish to experience in the program locations you selected. Please leave blank if you would rather we determine your activities according to your educational objectives.
Backpacking      
Service Work
Rock Climbing        
Rappelling        
Ropes Course        
Whitewater Canoeing          
Whitewater Rafting          
Coastal Canoeing        
Sea Kayaking    
Snorkeling          
Mountaineering          
Initiatives
Workshops
Budget – If a major determining factor for the program is your budget, please let us know how much funding you have available.
Accompanying Adults – Will faculty members or parents be accompanying the participants during the program?
Yes No
Any Further Information

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North Carlina Outward Bound Schools