Plan Organize or Host a Dialogue

Plan, Organize or Host a Dialogue

First Name

Last Name

Email

What is the organization you would like to request a dialogue for?

What is your title?

What is the best phone number to reach you?

Did you want to host a dialogue?

Yes No Other

What is the specific topic or issue you'd like to discuss?

What is your preferred format for the dialogue (e.g., in-person, video call, phone)?

In Person Virtual (Online) Hybrid (Both) I am not sure and need more information Other

Are there any particular perspectives or viewpoints you're hoping to explore?

Do you have a specific location in mind? (Skip if N/A)

Are there any specific questions or concerns you'd like to address?

Are there any specific outcomes or actions you'd like to see as a result of the dialogue? Do you need facilitators?

When are you available to meet?

How long do you envision the dialogue lasting?

One Dialogue Series (2-6 Dialogues) Project (Ongoing with an assigned team) Other

Will this dialogue be for a specific group or open to the public?

Open to the Public! Invited Participants only Other

info@daysofidialogue.org

Institute for Non-Violence – Days of Dialogue is a fiscally sponsored project of Community Initiatives

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