Week of Dialogue

Bridging Cultures:
Co-Creating Networks of Cooperation
February 28th - March 4th, 2011

PARTICIPATION PROPOSAL FORM

Contact Details

           
Student Group/ University/ School/ Institution Institutional Affiliation (if applicable)

           
First Name of Applicant Last Name of Applicant

           
Email Address Phone Number

           
Website Address Mailing Address

           
State/ Province, Country Postal/ Zip Code

Scheduling

Proposed Time of the Day (between February 21st- 27th, 2011):

Day of the week:       Date (dd/mm/yy):      

Time:      

1
Proposal
Please submit your proposal as a .doc, .rft or .pdf attachment

1. Title (No longer than 10 words):      

2. Format of proposed activities (check one or more if applicable)

Roundtable discussion
Individual or panel presentation
Interactive workshop
Dialogue process
Other:

3. Content Description – Maximum 200 words

     

4. Session objectives: what knowledge or skills will participants gain? –

Maximum 100 words

     

5. Content Summary or Abstract — Maximum 100 words. If selected, this may be

used for program brochure and website.

     

6. Biography — Please provide a brief bio of 50 words for each presenter

     

7. What is the mission of your organization?

     

8. Please provide a short description of your organization, and your activities is recent years