STRIVE WorldWIDE Pilot Application &Technology Self-Assessment
Thank you for your interest in participating in STRIVE WorldWIDE's pilot course. STRIVE is a nonprofit organization based in South Portland, Maine. Over the past 20 years, STRIVE has provided social, educational, employment training and post-secondary educational opportunities for tweens, teens, and young adults with intellectual disabilities. STRIVE WorldWIDE offers online programming for independent living to individuals across the state, country, and worldwide! The purpose of STRIVE WorldWIDE is to further STRIVE's mission of providing opportunities for increased independence. It will provide training and skills building to a wider audience that would otherwise be unable to access STRIVE's programming.

The curriculum is designed for individuals with intellectual and developmental disabilities but open to all who may benefit.

The pilot course is focused on personal safety. It will be a 5-week course beginning April 1, 2019, running through May 5, 2019. Each week will represent one unit (topic) we cover about personal safety. Each week we will host 2 online seminars on Mondays and Wednesdays from 7-8 PM. There is a $10 technology fee for all participants. Space is limited!

Pilot Objectives: By the end of this course, learners should be able to….
1. Identify basic proactive safety skills and techniques.
2. Recall personal contact information.
3. Define safe and responsible use of social networking and technology.
4. Distinguish irregularities in your physical and/or mental well-being.
5. Explain the difference between emergency and non-emergency needs.
6. State practices for routine preventative care.

Email address *
What is your first name? *
Your answer
What is your last name? *
Your answer
What is your email address? *
Your email address will be used to create your username for the course and communications for the course will be sent to the email address provided.
Your answer
What is your home address? *
Please include city and state.
Your answer
What is your date of birth? *
You must be 16 years old or older to participate in this pilot program. There is no age limit.
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How do you plan to access this course? Choose all that apply. *
Much of the course can be accessed via your phone or tablet, but you will need access to a computer in order to access the seminars.
Required
Have you been diagnosed with an intellectual disability? *
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