From Surviving to Thriving:
A Collaborative Summit for Leaders in Nonprofits
Wednesday, May 25, 2005 - 8:30 - 4:00
668 13th Street, Oakland
Registration Form
Paying with a CHECK? Print this form, for fax or mail.
Paying with a CREDIT CARD? Register on-line by clicking here.)
Organization Name:
Address line 1:
Address line 2:
City Zip
Participant #1: Title:
E-mail: Phone:
Mailing address if different from above:
Participant #2: Title:
E-mail: Phone:
Mailing address if different from above:
Participant #3: Title:
E-mail: Phone:
Mailing address if different from above:
(Please use a second form for additional participants.)
Registration Fees (including continental breakfast and lunch):
1st Participant from each organization $ 125 _____
Additional Participants at $75 each ( ) at $75/ea = _____
Total enclosed (checks payable to Inspiring Results) _____
Additional Information:
What services does your organization provide, and to whom?
What do you need from the Summit to feel like it was successful for you?
Because the process will build progressively throughout the Summit, it is extremely important for you to attend the entire session. Are you committed to attending the whole day? ______ Yes ______ No
Do you have any special needs (accessibility, dietary, etc.)?
Who else would you like to receive a notice of this Collaborative Summit?
Contact Name:
Organization Name:
Address 1:
Address 2:
City: Zip
Telephone: E-mail:
On receipt of your registration and payment, we will send a confirmation including additional information on the site, parking, and BART access.
Please MAKE CHECKS to Inspiring Results and mail registration and check to:
Nancy Ogilvie
Inspiring Results
20993 Foothill Blvd. #321
Hayward CA 94541
(Questions or Fax) 510-690-0467
nancy@inspiring-results.com