2017 NorCal Permaculture & Building Resilient Communities Convergence! Convergence Workshop Application
Thank you for taking the time to apply to offer a workshop at the 2017 NorCal Permaculture & Building Resilient Communities Convergence! The priority deadline for workshop submissions has been extended to 5 PM on Friday July 15th. If you would like to apply for more then one presentation please fill out this form separately for each presentation.

Giving a workshop at the Convergence is an opportunity to showcase you and your work to a wide audience of peers and the public at large. We are offering workshop presenters a range of 35% off Convergence tickets, and an opportunity to apply to our Equity and Inclusion Fund as well. If you have specific questions, requests, or needs regarding your participation, please let us know at the end of this application.

First and Last Name *
Your answer
Email address *
Your answer
Phone Number *
Your answer
Where do you live?
Your answer
Organization(s) you are affiliated with
Your answer
Website(s)
Your answer
Declaration of Diversity. How do you identify yourself? (NOTE: this question is optional).
We are interested in crafting a deeply diverse experience, representing the many voices of our Movement. Please define yourself in terms of demographics including ethnicity, age, gender, sexuality, etc. We want to know who you are!
Your answer
Workshop Theme / Track
We are looking for workshops in the following themes below. What is the primary theme or topic of your workshop? (please refer to the website for track descriptions).
Type Of Workshop Offered
We have 3 types of workshop formats available: 1) 1 hour workshops. 2) Panel Discussions will run from 1 - 1.5 hours. 3) Project presentations are 20 minutes. Please let us know what type of presentation you would like to offer (You may apply for more than one):
Proposed Workshop Title *
What is the name of your workshop?
Your answer
Workshop Summary *
Please give us a short paragraph description (4-5 sentences) about your workshop. Use third person if speaking about yourself. This will appear as the workshop description on the website.
Your answer
Please write a one-sentence description about your workshop.
This description will be used for promotional materials and our written program.
Your answer
Workshop Details. Tell us more.
How is this topic relevant to Permaculture & Building Resilient Communities? What will participants gain from participating? Is this topic related to "Building Bridges" between groups, places, ideologies, etc in any manner? How will it be presented? How can your workshop help to grow our Movement? Please note that we highly encourage interactive, experiential, hands-on workshops.
Your answer
Session Resources for Workshop *
Please tell us what materials you may need to present your workshop. We have limited spaces for powerpoint presentations and would like to encourage you to present a workshop that DOES NOT require a powerpoint projector if possible.
Required
Co-presenters
If you are leading a panel discussion or have a co-presenter, please tell us his/her/their names and affiliation. They should also submit a bio and head shot.
Your answer
For All Applicants- Panel Discussions *
Given the large number of workshop submissions we will receive and the limited number of spots available, we may combine some workshops into a group presentation or panel discussion format. Would you be interested in co-presenting or being part of a panel discussion around your workshop topic?
Additional ideas for workshops and presenters
Please write any ideas or topics for other workshops or panel discussions you may be interested in participating in, as well as any other presenters you would like to see speak at the Convergence.
Your answer
What is your preferred time and availability for your workshop? *
The more flexible you are, the more likely we will be able to schedule your workshop. If you are flexible feel free to select more than one choice, or anytime.
Required
Date Restrictions
Please write any days/times in which you can NOT offer a workshop. Be as specific as possible with dates AND times.
Your answer
Your Bio *
Please write a short paragraph about yourself (in 3rd person) describing your relevant experience, which we will be publishing in promotional literature on our website.
Your answer
Your Background
Please tell us a bit about yourself and your qualifications to offer this presentation.
Your answer
Become a Community Partner! *
Giving a workshop at the Convergence is an opportunity to showcase you and your work to a wide audience of peers and the public at large. We are asking all workshop presenters to support the Convergence by becoming a Community Partner and linking to the Convergence on your website(s), sending a promotional email to your individual organization's email list, and making a post on social media. In turn, the Convergence will list your organization as a Community Partner on our website, promotional materials, social media streams and programs. Please list the groups or organization(s) name(s) and website(s)you would like to become Community Partners of the Convergence.
Your answer
Head Shot
Please email a head shot photo to go along with your bio in the format of: "First Name_Last Name.jpeg" to: workshops@permacultureconvergence.com. Demonstrating the ability to follow through on this in the correct format is a perk. Don't make it harder for us.
Image/photo to represent your workshop
Please email an image to go along with your workshop (which will be displayed next to the workshop description on the website) in the format of: "First Name_Last Name_Workshop Title.jpeg" to: workshops@permacultureconvergence.com. Demonstrating the ability to follow through on this in the correct format is a perk. Don't make it harder for us.
Webcast
Would you be interested in offering a brief wecast or on-line presentation leading up to the Convergence?
Final Questions or Comments
Do you have any other comments or questions about workshops, the program, or the Convergence in general? You may also email: workshops@permacultureconvergence.com
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms