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CITIZEN SUMMIT IV
 Participate
Volunteer
Facilitate

CITIZEN SUMMIT III

LGBT CITIZEN
SUMMIT



Registration Form

Facilitator Registration Form Online

Facilitators are a key to the success of the summit, so please review the required skills and commitment before completing the application. To volunteer as a facilitator, please complete the form and submit. We will follow-up with you shortly to confirm your participation. If you have any question or need more information before volunteering, please contact the facilitator coordinator.

Required Skills for Facilitators
  • Experience facilitating small groups in building consensus
  • Capacity to adhere to timelines and specific instructions
  • Strong listening skills and comfort with diversity on many
        dimensions
    		•   Required Commitment for Facilitators
  • Attend an orientation session prior to Citizen Summit IV
  • Be able to attend Citizen Summit IV for the length of the event
  • Providing feedback and evaluation at the conclusion of the Citizen Summit

    • Contact Information
    Prefix
    		 First Name
    		   Initial Last Name   Suffix

    City:   State:     

    Email:
    Would you be comfortable facilitating in one of the following languages?
    Spanish Chinese (Mandarin)
    Korean American Sign Language
    Vietnamese
    Other  

    Summit Information
    Have you attended a previous Citizen Summit?
    Yes No
    Have you been a facilitator at a previous Citizen Summit?
    Yes No
    How many years of facilitating experience do you have?
    1-2 years 3-5 years 5-plus years

    Orientation Sessions
    New Facilitators: Please choose a orientation session from the following list:

    Refresher Sessions
    Returning Facilitators: Please choose a refresher session from the following list:

    All orientation and refresher sessions will be held in the Mayor’s Press Briefing Room, on the Ground floor of the John A. Wilson Building, 1350 Pennsylvania Avenue NW, Washington DC (near the Metro Center and Federal Triangle Metro stations).

    Demographic Information (optional)
    Gender
    Male Female
    Age
    Under 22 23-34 35-54 Over 55
    Race
    American Indian or Alaskan Native
    Asian or Pacific Islander
    Black or African American, not of Hispanic origin
    White, not of Hispanic origin
    Hispanic or Latino(a)
    Other