2012 Connecting for Change Workshop Proposal

The 2012 Workshop Proposal Deadline is March, 31st. We look forward to receiving your proposal and will do our best to get back to you regarding it.

First Name: *

Last Name: *

Organization Name:

Address: *

City: *

State: *

Zip Code: *

Phone: *

Fax:

Email Address: *

Website:

Additional Contact Person:

Workshop
Please keep in mind that our workshop presentations are 90 minutes in length.

Workshop Title: *

Presenters: *

Also because we receive so many proposals we may ask you to present with other people/organizations, are you ok with this?: *

Yes

Remember it will incrase your odds of being invited if you are able to participate with others.

Workshop Description: *

Target Audience: *

Optimum Number of Participants: *

Organization Description:

Refrences: If available, please include website links to online videos.:

How did you hear about Connecting for Change?:

Have you attended Connecting for Change?:

If Yes, what year(s)

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