Leadership Conference Registration Form 2017

Leadership Conference Registration form 2018

Join us for the 7th annual South Shore Leadership Conference! The goal of this FREE conference is to build leadership skills to enable local residents to become actively engaged in advocacy work in their communities.

7th annual
SOUTH SHORE LEADERSHIP CONFERENCE
Saturday June 10th, 2017
8:30 AM to 3:00 PM
West Middle School
271 West Street, Brockton

Questions? Call The Family Center at 508-857-0272 or email Janine.dilorenzo@ccbrockton.org

Question Title

* 1. Please enter your information below:

Name

Organization (if applicable)

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Demographics: please select your age range.

13 - 18

18 - 25

26 - 35

36 - 45

46 - 55

56 - 65

65 +

Question Title

* 3. What workshop tracts are you most interested in? Check all that apply.

Family and relationship development

Community matters

Emotional wellness

Education

Leadership / empowerment

Community organizing & activism

Question Title

* 4. Lunch will be provided at the conference. Vegetarian Meals can be provided upon request.

I would like to request a Vegetarian Meal.

Question Title

* 5. Will you need childcare during the conference?

Please note: childcare will only be provided for children age three (3) and older. Parents/Guardians MUST remain in the building throughout the Conference.

Yes - I will need childcare during the conference

No - I will not need childcare

Conference Program

8:30 - 9:00 am Check-in / visit Resource Tables
9:00 - 9:30 am Welcome, Spoken word
9:30 - 10:30 am Panel of speakers / q & a
11:00 - 12:00 pm Break out sessions
12:00 - 1:00 pm Lunch, resource tables, information sessions
1:00 - 1:30 pm Dancing, music, cultural arts & presentations

For more information:
Contact Janine DiLorenzo at (508)-857-0272
Email: Janine.dilorenzo@ccbrockton.org
Website: http://www.ccbrockton.org

Question Title

Question Title

* 1. Please enter your information below:

Question Title

* 2. Demographics: please select your age range.

Question Title

* 3. What workshop tracts are you most interested in? Check all that apply.

Question Title

* 4. Lunch will be provided at the conference. Vegetarian Meals can be provided upon request.

Question Title

* 5. Will you need childcare during the conference? Please note: childcare will only be provided for children age three (3) and older. Parents/Guardians MUST remain in the building throughout the Conference.

Question Title

* 5. Will you need childcare during the conference?

Please note: childcare will only be provided for children age three (3) and older. Parents/Guardians MUST remain in the building throughout the Conference.