Thank you for your interest in holding your convening at the Winthrop Rockefeller Institute. Please complete this brief survey about your proposed convening so that we may coordinate the best option for your meeting. Institute staff may follow-up with additional questions depending on your answers.
 
If you are interested in our Virtual Convening Package, please answer each question and indicate your desire to meet virtually in the answer to the final question, number 16.

Thank you again for your time and your interest in the Winthrop Rockefeller Institute.

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* 1. Contact First Name:

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* 2. Contact Last Name:

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* 3. Contact Email:

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* 4. Contact Phone (format (123) 123-1234):

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* 5. Organization name:

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* 6. Organization location (city, state):

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* 7. What affiliation does your organization have? Select one.

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* 8. What is the goal of your convening?

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* 9. Who will be invited and/or required to attend?

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* 10. What organizations, businesses, nonprofits, government agencies, etc. will be represented if your invitees can attend?

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* 11. What type of work will happen at your convening? Choose as many as apply.

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* 12. Estimated number of attendees?

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* 13. Will your agenda accommodate a ten-minute talk, delivered by a Winthrop Rockefeller Institute employee, to share the mission of the Institute, our history, and the work of Governor Winthrop Rockefeller? (Delivered at no charge to your organization.)

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* 14. What made you choose the Winthrop Rockefeller Institute for your convening?

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* 15. Will you require overnight accommodations?

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* 16. When would you like to gather? Please list all possible dates or a date range. If certain days of the week are a necessity, include that here.

Thank you for filling out this application. A conference services representative will connect with you within 5-10 business days. If your application is considered, you may be asked to provide more information about your organization and/or your proposed convening.

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