Conversations of Consequence: Civil Discourse Training Registration

Please complete this form and submit by pressing "done" in order to register for the event:

Conversations of Consequence Civil Discourse Training

Saturday, September 29, 2012
9:00 a.m. - 3:00 p.m.

Iliff School of Theology - Great Hall
2201 S. University Blvd.
Denver, CO 8-0210

A light lunch will be served.

1. Name (first and last):

Name (first and last):

2. What is your affiliation (please enter descriptors for all that apply)?

What is your affiliation (please enter descriptors for all that apply)? Community Member (Please identify your community-based affiliation):
Campus Student (Please name your university/school):
Campus Staff (Please name your university/school):
Campus Faculty (Please name your university/school):

3. What is your email address?

What is your email address?

4. Please note any food allergies or preferences (i.e.: vegetarian):

Please note any food allergies or preferences (i.e.: vegetarian):

5. Please let us know if you will need any special accommodations:

Please let us know if you will need any special accommodations:

6. Please share with us what, if any, previous experience you have facilitating civil discourse, and in what context (i.e.: neighborhood association, church, etc.):

Please share with us what, if any, previous experience you have facilitating civil discourse, and in what context (i.e.: neighborhood association, church, etc.):

7. What do you hope to learn at this training?

What do you hope to learn at this training?