Confident Life Program™ Request Form - MTA

Identifying needs and key demographics.

Understanding the needs of your school or youth organization is an important first step in selecting the right program to deliver. For instance, schools often recognize the value of social and emotional learning (SEL) for students, though not all will opt to include the Parent program or regular administrator training. Some organizations may choose to start with the training component and later incorporate the student-focused curriculum.

1) Have you evaluated the necessity of the Confident Life Program™ Student Curriculum, Parent Program, or Administrator Training Program?

Yes No

2a) Which grade levels will you target for the program? (Select all that apply.)

2b) Additionally, please provide the estimated number of children in each grade.

3) Which curriculum duration would best meet the needs of your students?

Full-Year Program: 30 class sessions (one session per week) Accelerated Program: 15 class sessions (one session per week for 15 consecutive weeks)

4) What type of organization will be responsible for delivering the Confident Life Program™?

Public Elementary School Private Elementary School Homeschool Group Youth Organization (Ex: Boys and Girls Club, YMCA, Community Center, Scouts) Youth Mental Health Agency Pediatrician or Doctor’s Office Other

5) In which languages do you provide services for students and parents?

6) What funding sources are used to support SEL programs within your organization?

7) How did you hear about the Confident Life Program™?

8) Have you engaged with the organization's administrative management to discuss the Confident Life Program™ goals, research, and delivery methods to evaluate their motivation and support for its implementation?

Yes No

9) If the administration decides to implement this program within your organization, what would their expected start date be?

10) If the administration showed a lack of enthusiasm, what barriers or challenges were identified? In the event the program is adopted, how will these obstacles be addressed?

11) Who will deliver the Confident Life Program™ to students?

Regardless of an administrator's educational background, the most effective group leaders tend to be those who are adaptable and thrive in a collaborative teaching environment. Additionally, a strong understanding of early childhood development and cognitive social learning therapy proves highly beneficial.

12) Have particular individuals been identified to undergo training for implementing the Confident Life Program™ at your school or youth organization?

Yes No

13) The Confident Life Program™ complements existing SEL initiatives effectively. What other programs are your students currently participating in or have recently completed?

Each session includes protocol checklists that outline the content to be covered, the distribution of Parent's Guides, key role-plays, activities, and the issuance of a Certificate of Completion for students. Administrators are asked to complete both a Readiness Survey and a Final Survey, which play a crucial role in monitoring and ensuring the program's delivery integrity.

Which individuals within the organization will be responsible for reviewing program fidelity, ensuring surveys are completed on time, and managing the processing of checklists during program delivery?

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CLP Request Form: Schools & Organizations

School & Youth Organization Form

Identifying needs and key demographics.

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