Fall 2024 TableTalks™ Registration

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TableTalks is a forum for discussing practical solutions and brainstorming ideas in a confidential, safe and comfortable setting. We look forward to seeing you at the table!

Email *

First Name *

Last Name *

Gender Pronouns *

She/Her

He/Him

They/Them

Other:

Organization Name *

Job Title / Role *

Best Mailing Address (If working from home, please provide home address) *

Best Phone *

Organization Website *

Why are you registering for this peer learning series? *

Please indicate which group you would like to register for. (All Times are Pacific Time) *

ZOOM Executive Leaders: Fridays 9am - noon (Facilitator Mia Ellis)

ZOOM Development Professionals: Tuesdays 2pm - 5pm (Facilitator Deb Salls)

ZOOM Development Professionals: Wednesdays 2pm - 5pm (Facilitator Deb Salls)

Zoom Executive Leaders: Mondays 2pm-5pm (Facilitator Deb Salls)

Required

Do you consent to having your picture taken and possibly used in future marketing materials?

Yes

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Registration Fee: *

I will be paying the $415 registration fee

I will be paying the Early Bird $395 registration fee (register by 8/1/24)

Required

Payment Methods

Payment to be directly remitted to your facilitator. Email for more information:

Deidre McCormack Martin – dmccormack@familylawcasa.org

Mia Ellis -- mia@amplifyleaders.com

Deb Salls – debsallstabletalks@gmail.com

Thank you!

A copy of your responses will be emailed to the address you provided.

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