Oregon Funding Workshops Survey

Thank you for your interest in attending the free Oregon Funding Workshops. We encourage you to forward information on the workshop to those who may be interested in attending. The Agenda can be found at the end of this form.

Please fill out the information below.

A confirmation will be sent to you with any updated information.

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1. Please choose the location and an alternate location (if applicable) you would like to attend. If your first choice is not available, you will be assigned to your second choice location.

	1st Choice	2nd Choice, if any
July 12, 9:00am Klamath Falls	*Please choose the location and an alternate location (if applicable) you would like to attend. If your first choice is not available, you will be assigned to your second choice location. July 12, 9:00am Klamath Falls 1st Choice	July 12, 9:00am Klamath Falls 2nd Choice, if any
July 12, 2:30pm Medford	July 12, 2:30pm Medford 1st Choice	July 12, 2:30pm Medford 2nd Choice, if any
July 13, 9:00am, Gold Beach/Brookings	July 13, 9:00am, Gold Beach/Brookings 1st Choice	July 13, 9:00am, Gold Beach/Brookings 2nd Choice, if any
July 13, 2:30pm, Bandon	July 13, 2:30pm, Bandon 1st Choice	July 13, 2:30pm, Bandon 2nd Choice, if any
July 14, 9:30am, Florence	July 14, 9:30am, Florence 1st Choice	July 14, 9:30am, Florence 2nd Choice, if any
July 14, 2:30pm, Eugene	July 14, 2:30pm, Eugene 1st Choice	July 14, 2:30pm, Eugene 2nd Choice, if any

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2. Please provide your information below. Fill in all items. If not applicable, please indicate with "NA":

Please provide your information below. Fill in all items. If not applicable, please indicate with "NA": First Name:
Last Name:
Title:
Affiliation:
Address:
City:
Zip:
Phone:
Email:

3. Please indicate the sources of funds or technical assistance you are most interested in.

	Need right away	Very interested	Curious	Not interested
Business Development	*Please indicate the sources of funds or technical assistance you are most interested in. Business Development Need right away	Business Development Very interested	Business Development Curious	Business Development Not interested
Site Assessment and Cleanup	Site Assessment and Cleanup Need right away	Site Assessment and Cleanup Very interested	Site Assessment and Cleanup Curious	Site Assessment and Cleanup Not interested
Planning and Outreach	Planning and Outreach Need right away	Planning and Outreach Very interested	Planning and Outreach Curious	Planning and Outreach Not interested
Project Feasibility Analysis	Project Feasibility Analysis Need right away	Project Feasibility Analysis Very interested	Project Feasibility Analysis Curious	Project Feasibility Analysis Not interested
Water Infrastructure	Water Infrastructure Need right away	Water Infrastructure Very interested	Water Infrastructure Curious	Water Infrastructure Not interested
Transportation	Transportation Need right away	Transportation Very interested	Transportation Curious	Transportation Not interested
Project Construction	Project Construction Need right away	Project Construction Very interested	Project Construction Curious	Project Construction Not interested
Community Development	Community Development Need right away	Community Development Very interested	Community Development Curious	Community Development Not interested
Technical Assistance	Technical Assistance Need right away	Technical Assistance Very interested	Technical Assistance Curious	Technical Assistance Not interested
Capacity Building	Capacity Building Need right away	Capacity Building Very interested	Capacity Building Curious	Capacity Building Not interested
Historic Preservation	Historic Preservation Need right away	Historic Preservation Very interested	Historic Preservation Curious	Historic Preservation Not interested
Others(please indicate in the space provided)	Others(please indicate in the space provided) Need right away	Others(please indicate in the space provided) Very interested	Others(please indicate in the space provided) Curious	Others(please indicate in the space provided) Not interested

Please add topic(s) you are very interested in or are in need of.

4. Time permitting, would you be interested in a one-on-one consultation with the funding team? If yes, please describe the project/program you wish to discuss.

Time permitting, would you be interested in a one-on-one consultation with the funding team? If yes, please describe the project/program you wish to discuss. No

Yes. Please describe your project/program in the space provided.

5. The Agenda is found below. Each meeting will be approximately two (2) hours long:

a - Introductions
b - Summary of Funding & Technical Assistance Programs
c - Detailed Description of Funding & Technical Assistance Programs (as requested)
d - Adjourn/Break
e - As time permits, one-on-one sessions

If you have any questions or comments, please list here. Or, contact Karen Homolac at 503.986.0191 or karen.homolac@biz.state.or.us.

Thank you for your interest and we look forward to meeting you!
Please write any additional comments below.

The Agenda is found below. Each meeting will be approximately two (2) hours long: a - Introductions b - Summary of Funding & Technical Assistance Programs c - Detailed Description of Funding & Technical Assistance Programs (as requested) d - Adjourn/Break e - As time permits, one-on-one sessions If you have any questions or comments, please list here. Or, contact Karen Homolac at 503.986.0191 or karen.homolac@biz.state.or.us. Thank you for your interest and we look forward to meeting you! Please write any additional comments below.

Oregon Funding Workshops
Exit this survey

1. Oregon Funding Workshops

*
1. Please choose the location and an alternate location (if applicable) you would like to attend. If your first choice is not available, you will be assigned to your second choice location.

*
2. Please provide your information below. Fill in all items. If not applicable, please indicate with "NA":

3. Please indicate the sources of funds or technical assistance you are most interested in.

4. Time permitting, would you be interested in a one-on-one consultation with the funding team? If yes, please describe the project/program you wish to discuss.

Oregon Funding WorkshopsExit this survey

1. Oregon Funding Workshops

*1. Please choose the location and an alternate location (if applicable) you would like to attend. If your first choice is not available, you will be assigned to your second choice location.

*2. Please provide your information below. Fill in all items. If not applicable, please indicate with "NA":

3. Please indicate the sources of funds or technical assistance you are most interested in.

4. Time permitting, would you be interested in a one-on-one consultation with the funding team? If yes, please describe the project/program you wish to discuss.

Oregon Funding Workshops
Exit this survey

*
1. Please choose the location and an alternate location (if applicable) you would like to attend. If your first choice is not available, you will be assigned to your second choice location.

*
2. Please provide your information below. Fill in all items. If not applicable, please indicate with "NA":