"Engaging Others" Registration and Application (Prior to registering please carefully read the program details at www.InterculturalLeadership.ca/EngagingOthers) Contact information: Name (required) Preferred name: How you prefer your name to be written on name tags, etc. Email (required) Address (required) Telephone (required) Alternate phone In Person or Videoconference: We encourage you to be part of the face to face in person gathering. Some bursaries will be available to help with travel costs. In order to facilitate this as a Canada wide event we will offer an opportunity to join by videoconference from 11am - 1 pm (Eastern time). I plan to attend in person: yesno I plan to attend by videoconference: yesno Fees: Through grants from our member denominations we are able to keep fees low. Registration (includes meals) is $50. Videoconference only is $20. You are responsible for your own accommodation and travel in addition to these fees. When you complete and submit this form you will be sent an automatic confirmation email which will include instructions for paying fees. Accommodation: To keep costs down this will be a "commuter" event. We are hoping to facilitate billets for out of town participants. We will provide some suggested local accommodation for those who don't wish to billet (you or your sponsor organization are responsible for costs). You are also welcome to organize your own accommodation. Please check the following as they apply to you: yesno : I live locally and will commute from my home. yesno : I live locally and can provide a billet for people yesno : I am from outside Toronto and will need a billet yesno : I am from outside Toronto but do not require a billet (I will arrange my own accommodation) Travel: You are responsible for your own transportation to the gathering. We will provide information on transportation to and from airport, bus, and train stations. Together we will coordinate carpools and rides to and from billets. Travel and Accommodation Subsidies Participants are encouraged to use their own resources or apply to their denomination or sponsoring institution for travel costs. However to encourage participation from contexts across Canada there are also travel and accommodation subsidies for those who don't have these resources. I would like to apply for a subsidy yesno If so, please estimate the amount Participation invitation and sponsor information This is a gathering of people engaged in Intercultural Ministry in Canada. Participation is at the invitation of an organization or through application. Please indicate one or more below: I am participating at the invitation of a partner of the "Forum for Intercultural Leadership and Learning" If so, please let us know the name of the partner and who from the organization will confirm their sponsorship or other details of your conversation with them. I am participating as an alumni of the "Engage Difference! Deepening Understanding for Intercultural Ministry" program or at the invitation of the Forum for Intercultural Leadership and Learning. If so, please tell us the program(s) in which you participated. I am not a program alumni nor have I been invited by a partner organization to participate. yesno If so we would love to have you as part of this learning community. We will be in contact to ensure this program is a good "fit" for you and your needs. Personal information: Gender Decade in which you were born Denominational or institutional affiliation DUIM Program related information: As we will be learning together as a community it is important that you are present for the full program. Program runs 9:30 am Thursday to 4:30 pm. I can commit to attending the full program (answer required): YesNo There will be an optional community supper in the evening (aprox. 5:00 pm -7:00 pm). There is no additional cost for this meal. To help us estimate numbers for a reservation tell us if you are likely to be part of this social time: YesNo Please describe your ministry setting What are your primary goals for your participation in this this program? Perhaps what you hope will happen as we gather, what you hope to offer, what you would want to come away with? Special Dietary and Other Needs: Please describe any mobility or other ability issues: I prefer vegetarian entrées only: YesNo Other dietary needs or food allergies (if any) Other (non-food related) allergies (if any) Once you click "submit registration" watch below for a confirmation (scroll down). There will be a message below to confirm successful submission of this form or you will be asked to resubmit with missed information. An automated email will be sent to confirm that we have received your registration. If it does not arrive in your inbox in a few moments please check your junk mail/spam box.