Symposium Leadership Response Form - Due by Sept 15, 2009
Please complete the form by September 15th, 2009.
Press the Submit Button at the bottom after completing all answers that apply.
* Required
Name
*
Type your full name
I can be a facilitator
Leave blank if no
Yes
I prefer to facilitate/participate in the following track
Select any of the above if you have no preference
Urban Mission
Global Health
Environmental Stewardship
Interfaith Engagement
Educational Mandates
Corporate Ethics
Any of the above
I have a paper, article, song, PowerPoint, poem book etc. to recommend
Leave blank if no
Yes
Title
Title of the item
Subtitle
Leave blank if no subtitle
Author
Author if other than yourself
Year published and copyright by whom
Leave blank if unpublished original
How to use of this item
Select all that apply
A workshop track presentation
Background reading material
Documentation related to a workshop
Consider for publication in symposium products
Paragraph description
Short summary of this item to be used in conference materials
Personal profile
Your current work and background relation to the the legacy and future plans
Your website
If you have a website type the address below
Other questions, comments and suggestions