Dialogue Participant Information Form
Please respond to each prompt below to help us ensure diverse and balanced dialogue groups.
We do not share or sell personal information about participants with any other organization.
For more information, contact us at rhondah@interfaithconference.org or 414-276-9050.
First Name *
Your answer
Last Name *
Your answer
Mailing Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Mobile Phone
Your answer
Other Phone
Your answer
Email Address *
Your answer
Worldview or Religious Tradition *
Your answer
Race and Ethnicity *
You may choose multiple answers.
Required
Please indicate your interest in participating in Amazing Faiths Dinner Dialogues. *
You may choose multiple answers.
Required
What dinner or moderator training dates are you interested in attending, if any?
Dates that have been set are listed on the Amazing Faiths Dinners webpage. Please list all dates you are available to attend in order of preference. Note that a limited number of seats are available. If you are not selected for your chosen date(s), you may still participate at a future date! Leave blank if you do not plan to attend any of the dinners listed. You may sign up again when you see a date that works for you.
Your answer
How did you hear about this program?
You may choose multiple answers.
Please indicate any dietary restrictions.
Meals are vegetarian.
Your answer
Do you need assistance with stairs?
Please indicate any other concerns or questions below, or email Rhonda Hill at rhondah@interfaithconference.org.
Upcoming Dinner Dialogue dates and times will be published on the Amazing Faiths webpage and emailed to interested participants.
Your answer
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