Global Day of Conversation

I, (name), (title), of (City, State, Country, Civic/Environmental Organization) will be honored to be a participant in the 2011 Earth Day Network’s Global Day of Conversation.

My contact information is:


The primary contact for my community’s involvement is (if not same as above):


(name)
(title)
(telephone)
(email)

Facebook page:
Twitter handle:
Please list local newspaper (s):

Please list all government officials and their title who may participate in the Global Day of Conversation:
( format: name| title, )

Please provide a brief description of the event:

Have you hosted an Earth Day event in the past? If yes, when?

Have you hosted an Earth Day Network - Global Day of Conversation in the past? if yes, when?

What is the date(s) of your event?

What is the time of your event?

Where is the location of your event?

What issue (s) will be discussed during this year’s Global Day of Conversation?

How many to you expect to be in attendance?

Global Day of Conversation is international!  Earth Day Network has a team, both domestically and internationally, working on bringing together communities to discuss how to achieve a global green economy.

Do you have a Sister City?  If so, would you like to connect your Global Day of Conversation event with them? 

Please list your city or multiple cities.

Would you like us to contact your Sister City?

Yes

No

Can we quote you for media and funding purposes?