Registration Form for Community Development Conference.doc

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Community Development:
Collaboration in Action
Saturday
April 28, 2007
Damon City Campus
Monroe Community College
228 East Main Street
Rochester, New York 14604
8:00 a.m. to 2:30 p.m.
Registration Form
Your Name (Please print) ____________________________________________
Address __________________________________________________________
Telephone Number _________________________________________________
E-mail ___________________________________________________________
Please check one of the following:
MCC Student _____ MCC Faculty/Staff ______ Conference Presenter ________
Student _____ (not MCC) Please indicate what school that you attend ___________
Agency Representative _____ Please indicate what agency you represent __________
Check the following:
I will be attending the free continental breakfast.
I will be attending the free luncheon
yes ____ no ____
yes ____ no ____
Please indicate your 1st, 2nd and 3rd choice for each workshop:
Session One 10:15 a.m. to 11:15 a.m.
1) “Grant Writing” Dr. Mary Handley ____
2) “Collaboration with Gangs” Officer Moses Robinson ____
3) “Reclaiming Rochester: Census Track 57” Prof. Tim Weider ____
4)
“Interfaith Action” Brian Kane ____
5) “ Student Session” Mark Homan” ____
(students only)
Please indicate your 1st ,2nd and 3rd choice for each workshop:
Session Two 11:30 a.m. to 12:30 p.m.
1) “Rochester Fatherhood Initiative” Todd D.Williams ____
2) “Neighbors Building Neighborhoods” Timothi Davis Howard ____
3) “The Children’s Zone” Denise Bartalo, Don Bartalo, Shaunta Collier Santos, Sherri
Lise, Lakita Munden, Carol Robinson, Lorna Washington and Maribel Torres ____
4.) “North East Area Development- NEAD George Moses and Ryan Vanalstyne ____
5.) “Student Session” Mark Homan ____ (students only)
Conference Schedule
8:00 a.m.
8:25 a.m.
8:30 a.m.
10:15 a.m.
11:30 a.m.
12:30 p.m.
1:15 p.m.
1:30 p.m.
2:20 p.m.
Sign-in and Continental Breakfast
Welcome and Introductions
Overview: Community Development: Mark A. Homan
Workshop Series One
Workshop Series Two
Pasta Buffet
Welcome and Panel Presentation
Round Table Sessions
Commencement
Registration Procedure
Please fax this form to Paula M. Fahy at (585) 262-1636 or mail to:
PAULA M. FAHY
HUMAN SERVICE DEPARTMENT
DAMON CITY CAMPUS
228 EAST MAIN STREET
ROCHESTER, NEW YORK 14604
Deadline for Receiving Conference Registration is:
Monday, April 16, 2007
After that date please call to see if there are spaces still available. For more information
please call the conference office at 262-1640.
There is no fee for this conference. This conference is sponsored by the Human Service
Department and a Perkins Grant
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