Community Roundtable- Facilitator Application
First & Last Name *
Your answer
Email *
Your answer
Company/Organization Name *
Your answer
Title *
Your answer
LinkedIn profile URL *
Your answer
What is the Title of your Roundtable? *
Your answer
Describe your Roundtable Discussion. *
Your answer
Describe how you will promote or list the people/organizations you would invite to participate in the roundtable. *
Your answer
Why are you the best person/team to facilitate the roundtable? Have you ever lead a roundtable before? (100 words max) *
Your answer
Have you or your organization signed up as a community partner, media partner, volunteer or sponsor with Futurist? *
I understand that the Community Roundtable is weather permitting outdoors on the upper deck. *
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