|
|
|
Earth Community Organization (ECO)
Participants to the Global Dialogue 2006 must register.
There are no registration fees. One registration per form.
Ms. Mr. Mrs. Dr. First name: ________________________________________ Last Name: _____________________________ __________________________________________________________________________________________ Title/Position: ______________________________________ Department: ____________________________ Organization: ______________________________________________________________________________ Address (street number and name): __________________________________________________________________________________ City: ____________________________________________________________ Province/Territory: _________________________________________________ Country: _________________________________________________________ Postal Code: _____________________________________________________ Telephone: _______________________________ ext: _______________ Fax: ________________________ E-mail: __________________________________________________ Website: _________________________________________________ Sector: Federal Government Provincial Government Municipal Government Corporate Academic NGO Media Student Other (please specify): ____________________________________________________________________
Are you making a presentation? Yes
 No
If yes, title of presentation:_________________________________________________ Short summary: _________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Are you organizing a Workshop Session in your community? Yes No
____________________________________________________________________ If yes, do you need help other than monetary help? Contact us if needed. Describe your Worksho Session (goal, issue(s), place, participants, day and time, results, recommendations, etc.): ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Do you wish to participate in a Discussion Roundtable on Internet? Yes No
What issue(s)? ____________________________________________________________________ ____________________________________________________________________
Contact information Germain Dufour Telephone (250)- 754-0778
For the Main Index of Global Dialogue 2006:
Return your completed form to: Germain Dufour Project Officer Global Dialogue 2006 186 Bowlsby Street, Nanaimo, BC, Canada V9R 5K1 or send your info by email at: globalcommunity@telus.net General Information Webmaster: gdufour@globalcommunitywebnet.com websites: http://globalcommunitywebnet.com/gdufour/ http://www.globalcommunitywebnet.com/globalcommunity/ http://www.globalcommunitywebnet.com/globalcommunity/globaldialogue.htm http://www.globalcommunitywebnet.com/globalcommunity/globaldialogue2006.htm Back to top of the page
 |
