Dodge Foundation - 2006 Technical Assistance Workshops Registration Form

2008-2009 Dodge Foundation
Technical Assistance Registration Form

REGISTER EARLY! Workshop participants will be selected on a first-response, first-served basis.
Please submit one form for each person attending.
Please note a team is required for each workshop and the Executive Director (or comparable position)
must be a consistent participant. Please check each workshop’s attendance guidelines.
When you register online, you will receive an automatic confirmation that your form has been received.
However, an official confirmation indicating acceptance into the workshop(s) will be sent after
your application has been reviewed. Please call if you do not receive this second confirmation.
Questions? Call Wendy Liscow at 973-540-8442, x127 or e-mail wliscow@grdodge.org or
call Lisa Bregman at 973-540-8442, x131 or e-mail lbregman@grdodge.org.

REGISTRATIONS MUST BE RECEIVED AT LEAST THREE WEEKS PRIOR TO WORKSHOP DATE.

Contact Information
Prefix
First Name	*
Last Name	*
Middle name
Suffix
Title	*

Organization
Organization Name	*
Address	*
Address cont.
City	*
State	*
Zip	*
Phone	* Extension
Fax
Email	*

For the Executive Director ONLY: Please tell us what challenges and opportunities are currently facing your Board and why your organization would like to participate in the workshop series:

Workshops
BoardCorps Bootcamp
Care and Feeding of Quality Board Members
Measuring What Matters
The Board’s Role in Fundraising
Board Financial Management
A Strategic Approach to Strategic Planning
Board/Executive Director Relationship
The Board/Founder Relationship: Making it Work
Board and Executive Leadership on the Edge
Building Community Through Technology: Web 2.0
ABC’s of EFFECTIVE INSTRUCTION