Interest & Suggestions Form

Like the first National Conference on Dialogue & Deliberation, the 2004 conference is a highly collaborative endeavor. If you are interested in attending the conference, helping to organize it or contributing to it in any way, please let us know by completing this form. Feel free to provide us with suggestions and ideas for the 2004 Conference in the text box below.

Also, by completing this form with your current email address, you will be added to the conference updates mailing list which will provide periodical updates about the conference throughout the summer and fall.

Name:?

Email:?

Phone:?

Please briefly describe your involvement with the dialogue & deliberation community (unless you already have a relationship with NCDD):

Please indicate whether you are interested in?

??being kept up to date on plans for the conference

??attending the conference

??helping to organize the conference

??presenting a workshop or session at the conference

??making a donation to the conference

?? co-sponsoring the conference ($5,000 donation)

?? partnering with NCDD to make the conference happen ($1,000 donation)

Is there something else you would like to tell us, or would you like to contribute in a way that is not listed above? Please feel free to add suggestions about the planning stage, as well.

Having problems with this form?

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