Discussion Circle Nomination

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Please fill out this form to nominate yourself or someone else to participate in person in the discussion circle at OBIC for UUCC's Conflict Resolution event on June 21st from 6-9pm. If there are more nominations than seats available, the GRW will select participants based on the responses to these questions to ensure a balance of perspectives. Final selection will also depend on willingness and availability of the nominee.

Email *

Who would you like to nominate to represent your interests at the in-person discussion circle at OBIC? (Please nominate yourself or another person by providing the full name.)

Preferred phone number for nominee (if known).

If there are key issues you feel need to be addressed to resolve the conflict(s) at UUCC, please list. (Please be concise.)

What is the strength of your feelings regarding the conflictual issues?

No concern

Extremely concerned

Clear selection

Comments (optional)

A copy of your responses will be emailed to the address you provided.

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