Changemaker Weekend:
Bring your whole crew! The more the better.

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This online form allows you to register for the Changemaker Weekend to be held February 4th thru 6th in Durham, North Carolina.  If you fill out and submit this form, we will call or e-mail you to confirm your commitment to attend.  We will also give you reminder phone calls leading up to the workshop weekend.  The information we ask you to enter in the form below will help the trainers better tailor the workshop to your needs.  It is to your benefit to answer the questions fully.

Note: You must be able to attend the entire workshop from Friday evening to Sunday afternoon (2:30). (Please contact us if you have questions about this. Read the FAQ.)

Registration for the Changemaker Weekend in Durham, NC (Feb 4-6th)
Please just fill this out and click the "submit" button at the bottom.


Name:
Street Address:
City/State:
ZipCode:
Daytime Number:
Evening Number:
Email address:
Year in School:
Do you have any special food needs?
No Preference Vegetarian Vegan Other needs (Please comment below)
Other needs:


How did you hear about the Changemaker Weekend?


Why do you want to attend the Changemaker Weekend?


What organization(s) are you currently involved in?

What is your role in that organization(s)? (member, staff, board...)

What issues are you currently working on?

What would you like to improve in your organization?

Have you attended other training programs? If so, which ones?

If you are an undergraduate, when will you graduate and what do you intend to do after graduation?

We look forward to seeing you Friday, February 4th!  To get the most out of the weekend, get as many members of your group to attend as possible!

Questions or comments? Contact:
Mary Grant mary.grant@duke.edu 672-1829