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Champions Retreat 2022 Interest Form
Thank you for your interest in supporting the 2022 Champions Retreat! This event will take place in Philadelphia during the week of November 28th-December 2nd. Please submit this form so we can know more about you, your interests, expertise, and your requests or offers. Questions? Email us at
championsretreat@usca.bcorporation.net
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First Name
Your answer
Last Name
Your answer
Email
Your answer
Company/Organization
Your answer
Is your company a Certified B Corporation?
Yes
We are a Pending B Corp
No, but we are actively pursuing B Corp Certification
No
Other:
Clear selection
Role/Title
Your answer
Where are you based?
Your answer
I am (or my company is) interested in: (check all that apply)
Speaking
Sponsoring
Pre-event planning
Volunteering at the event
Requesting additional financial support to attend Champions Retreat
Providing additional financial support for others in the community to attend
Other:
Please give us more specifics about your area of expertise and/or how you would like to contribute to the Retreat:
Your answer
If interested in speaking: please tell us what you would like to speak on. How will you integrate the pillars of the Theory of Change (Climate Justice, Racial Equity, Stakeholder-driven Economy)?
Your answer
If you will require additional financial support to attend Champions Retreat, please tell us more information about yourself and your request.
Your answer
If interested in sponsorship: how are you interested in sponsoring? (cash, in-kind, services, products, etc)
Your answer
Anything else you'd like to tell us?
Your answer
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