Ah, HA! Facilitating the Weaving of a Collaborative Network

Collaborative Facilitators

Your agency has been selected to submit a proposal to help shape the agenda and schedule for the Ah, HA! Transformational Event at the Broadmoor, May 16-17.

Please complete this short proposal form. You will be notified by April 10 if your proposal has been accepted.

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* 1. What topic session can you provide a master interactive facilitator for?

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* 2. What length of time and format do you propose?

I can lead fun fitness breaks

I can lead fun humor breaks

45 minutes

60 minutes

Round tables of 8 in the general ballroom with 350 will work just fine

A smaller breakout room space of 50-100 would work better (indicate preferred room set-up below)

It could be done as an interactive station during the Health Skills Fair on Saturday, May 17

Other details

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* 3. Please provide a short description of the proposed session.

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* 4. Please provide a short bio of the facilitator for the program

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* 5. Please tell us of a collaborative event where this person has provided services as a facilitator in the last year. Include a contact name and phone number of the event coordinator that has knowledge of the session and outcomes.

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* 6. What is the contact information for you?

Name:

Company:

Address 1:

Address 2:

City/Town:

State/Province:

ZIP/Postal Code:

Country:

Email Address:

Phone Number:

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* 7. What is the contact info for the facilitator?

Name:

Company:

Address 1:

Address 2:

City/Town:

State/Province:

ZIP/Postal Code:

Country:

Email Address:

Phone Number: