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Class Descriptions

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Class 1: World Cultures: Come and learn
about the different cultures of the world, in an
interactive environment.

Class 2: Bible Studies: Come and learn about


the bible and its history. L.E.A.D. is a program that
offers educational
Class 3: Fitness Class: Come and get in shape opportunities to individuals
at our fitness class. You will learn how to with developmental
exercise in a way that best suits your abilities. disabilities that live in the
St. Charles County area.
Class 4: Cooking Class: We will learn how to L.E.A.D. is funded by a

Richmond Heights, MO 63117


make some wonderful food and share with our generous grant provided by

1430 Woodland Dr. #1


D.D.R.B.

C/O Aaron Doubet


friends. Please note allergies on the form.

Class 5: Craft Class: Come and learn how to

LEADD
make wonderful crafts. We will learn to make
a new craft each week.

Class 6: Dogs 101: Have you ever wanted to


have a puppy. Have you wondered how to
care for that puppy. Then this is the class for
you.

The LEADD Fall 2010 Semester begins


September 18th and runs every Saturday to
October 16th from 9am to Noon.

LEADD Fall 2010 Schedule:


LEADD Fall 2010

09/18/2010: 1st Day of Class sign in begins


at 8:30am.

09/25/2010: 2nd Day


LEADD Fall 2010
10/02/2010: 3rd Day
Aaron Doubet
2200 Randolph
10/09/2010: 4th Day St. Charles, MO 63112

10/16/2010: Last Day. Graduation in last Phone: 314-560-9031


E-mail: doubeta@emmaushomes.org
class.
WEATHER LEADD Fall 2010 Class Registration
If classes are cancelled due to inclement weather, a re- Sign up for: Place a number 1-3 for the classes you want to register for.
corded message will be on Aaron’s voicemail at 314-560- Class 1 Worl Cultures
9031. Please call after 7 a.m. on the day of class. Class 2 Bible Studies
Class 3 Fitness Class
REGISTRATION
Class 4 Cooking Class
You must be at least 16 years of age to participate in Class 5 Craft Class
LEADD. Class enrollment is limited to 50 students on a Class 6 Dogs 101
first come/first served basis so please return the registra- Please complete the following application form. Please note you will
tion form early. Registration is due by XXXXX. You need to provide a copy of proof of eligibility for services from the
WHAT IS LEADD? will be given your schedule on the first day of class! State of Missouri Department of Mental Health. Students will not be
LEADD is a cooperative effort by Emmaus Homes CERTIFICATION OF COMPLETION allowed to attend without this documentation.
and St. Charles Community College’s Continuing A certificate of completion will be awarded to all students
Education Department to offer non-credit adult who attend 4 of 5 classes. The certificates will be distrib- Name

continuing education opportunities for persons with uted on the last Saturday at the end of the session. Address
developmental disabilities, ages 16 and older. Ses- TRANSPORTATION
sions are designed to teach independent living Students are responsible for their own transportation. Home Phone
skills and provide life-enhancing experiences in a DROP-OFF & PICK-UP TIMES
community educational and social environment. Drop off time is 8:45 a.m. Pick up is at 12 noon, please Gender: ___ Male ___ Female Date of Birth: ___________________
The curriculum aims to promote growth opportuni- Social Security Number: ____________________ Client ID #: _____________
arrive 10 minutes early. I am my Own Guardian: ___ Yes ___ No
ties and challenge the abilities for individuals who DROP-OFF & PICK-UP LOCATIONS
desire to live and work as independently as possi- Each Saturday, students are to sign in and out at St. Case Manager Name Phone Number
ble. Charles Community College in the Humanities Building Emergency Contact Name Phone Number
OUR MISSION at 4601 Mid Rivers Mall Drive, Cottleville, MO 63376
Emergency Contact Name Phone Number
LEADD will promote community membership, Directions:
academic growth, independence and personal en- From Interstate 70 - Drive South on Mid Rivers Mall Primary Care Physician Phone Number
richment through continuing education classes that drive for approximately 3 miles. The campus is located on What is your ethnic background: ___African American ___ Caucasian ___ Hispanic ___
support the needs of persons with developmental the right side of the street. Turn right onto Cottleville List all pertinent health and safety concerns:
disabilities and will enhance the opportunities for Parkway. Turn right at the first or second light to enter the ________________________________________________________________________________________

individuals to achieve positive outcomes in an edu- campus. ________________________________________________________________________________________

cational environment. From Highway 40 - Turn onto Highway 94 North. Turn ________________________________________________________________________________________
STAFF OPPORTUNITIES left onto Mid Rivers Mall Drive and drive approximately Capable of changing classrooms with minimal assistance. ______
If you are interested in teaching classes or acting as 2 miles. The college is located on the left side of the May participate in small group activities (8 – 12). ______
May remain seated for an hour. ______
a teacher’s aide, please contact either Aaron street. Turn left onto Cottleville Parkway. Turn right at Can follow simple directions. ______
Doubet at 314-560-9031. the first or second light to enter the campus. Able to transport and take medications independently. ______
Does not require extensive supervision for medical conditions______
ATTENDANCE Please Note Has no recent history of aggression. ______
It is your responsibility to come to class on time. If Due to the collaborative nature of the LEADD program; Able to maintain personal self-care and hygiene. ______
you arrive 15 minutes after the class has started, name, address, and birth date information will be shared Name of person completing this form: ___________________ Phone: ________________
you may not be admitted to that class. with St. Charles Community College for record keeping Relationship to the student: __________________________________________________
FEES purposes. All students will be required to show proof
Each session is $15 TOTAL. A session lasts 5 of their State of Missouri Department of Mental Student Signature: ___________________________________Date: __________________
weeks and is 3 hours of instruction each Saturday. Health eligibility for services. To obtain the needed
Make sure you are able to commit to 3 hours of document contact your case manager. I,
LEADD – Consent Form
_____________________, LEADD student agree to allow Emmaus
classes each Saturday. If you are unable to attend 4 Homes Inc. and St. Charles Community College to include me in photo displays and
out of 5 Saturdays, please refrain from registering videos. I understand that photo displays and videos may be used for teaching, training,

this session and re-register for the following ses-


LEADD Fall 2010 made possible through workshops, seminars and conferences. I have full authority to enter this agreement. It will
not violate any other agreement, understanding, commitment or the like with any party
sion. a generous grant from Developmental not referenced in this agreement.
________________________
REFUND POLICY Disabilities Resource Board. LEADD Student or Guardian Signature Date

To withdraw from a class, contact Aaron


I, _____________________________ hereby acknowledge that I have
Doubet at 314-560-9031. Refunds will be received this Notice of Privacy Practices.
given up to one week prior to the Session LEADD Fall 2010 __________________________________________________________
Consumer signature or Legal Guardian Date
start day.

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