ALF Oregon Urban Rural Connection Regional Participant Questionnaire
As a Regional Participant, you'll be a part of Regional Dialogues about how we build solutions through the connections we have, rather than being paralyzed by the divisions we perceive and/or experience. Regional Meeting dates and locations are listed below. The facilitated Regional Dialogues will run from about 9:00 AM - 12:00 PM. Given the nature of the conversation and programming, participants need to commit to the whole dialogue (9:00 AM - 12:00 PM) to facilitate the in depth conversations that will support this Project's success.

Regional Participant Commitments:

- Commit to attend a meeting of the Cohort, Regional Senior Fellows and local leaders to discuss what issues are key in your region.

- Consider inviting a regional leader you think would add value and perspective to this conversation, so that we can have a rich conversation.

Space is limited for each regional meeting, so if you want to participate and invite a guest we encourage you claim your spot in the Regional Dialogues ASAP.

Program Dates:

January 2018 - Salem (Meeting Location: Willamette University's Putnam Center)
- Monday, 1/8/18, 9:00 AM - 12:00 PM

February 2018 - Oregon Coast - Lincoln City (Meeting Location: Lincoln City Hall Chambers)
- Friday, 2/2/18, 9:00 AM - 12:00 PM

March 2018 - Southern Oregon - Medford (Medford Meeting Location: Harry & David Headquarters)
- Friday, 3/2/18, 9:00 AM - 12:00 PM

April 2018 - Central Oregon - Warm Springs (Warm Springs Meeting Location: Kahneeta Resort & Spa)
- Friday, 4/13/18, 8:30 AM - 12:00 PM

May 2018 - Eastern Oregon - Baker City (Baker City Meeting Location: Baker High School)
- Friday, 5/4/18, 9:00 AM - 12:00 PM

June 2018 - Portland (Portland Meeting Location: Mercy Corps Action Center)
- Friday, 6/8/18, 9:00 AM - 12:00 PM

More questions? Please contact Mariana Lindsay at mlindsay@aflo.org or (503) 757-6356.

Please share your contact and professional information below:
Name *
First and last name
Your answer
Email *
Your answer
Phone number *
Your answer
Mailing Address (street, city, state, zip) *
Your answer
Occupation + Sector *
Your answer
ALF Class Number/Name (answer N/A if participating as a local leader that is not a Senior Fellow) *
Your answer
I'm available for the entire time listed for my region and would like to participate as a Regional Participant in one of six regional dialogues. *
Please answer the following questions in 1 – 2 paragraphs:
As a Regional Participant, I will bring the following strengths, knowledge and skills: *
Your answer
I am interested in being in dialogue with leaders across the urban-rural divide because: *
Your answer
I'd like to invite a Regional Leader to join in this dialogue. In your answer, please include name, contact information, sector, and why you think this leader should participate in the regional conversation.
Your answer
Do you have any special accommodations?
Your answer
Do you have any dietary restrictions?
Your answer
Anything else you like to tell us?
Your answer
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