Email
Confirm email
I prefer to receive emails in HTML format
First Name
Last Name
Country
Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaidjan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia-Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Cook Islands Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Estonia Ethiopia Falkland Islands Faroe Islands Fiji Finland Former Czechoslovakia Former USSR France France (European Territory) French Guyana French Southern Territories Gabon Gambia Georgia Germany Ghana Gibraltar Great Britain Greece Greenland Grenada Guadeloupe (French) Guam (USA) Guatemala Guinea Guinea Bissau Guyana Haiti Heard and McDonald Islands Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Ivory Coast (Cote D’Ivoire) Jamaica Japan Jordan Kazakhstan Kenya Kiribati Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macau Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique (French) Mauritania Mauritius Mayotte Mexico Micronesia Moldavia Monaco Mongolia Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles Neutral Zone New Caledonia (French) New Zealand Nicaragua Niger Nigeria Niue Norfolk Island North Korea Northern Mariana Islands Norway Not answered Oman Pakistan Palau Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Island Poland Polynesia (French) Portugal Puerto Rico Qatar Reunion (French) Romania Russian Federation Rwanda S. Georgia & S. Sandwich Isls. Saint Helena Saint Kitts & Nevis Anguilla Saint Lucia Saint Pierre and Miquelon Saint Tome and Principe Saint Vincent & Grenadines Samoa San Marino Saudi Arabia Senegal Seychelles Sierra Leone Singapore Slovak Republic Slovenia Solomon Islands Somalia South Africa South Korea Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Islands Swaziland Sweden Switzerland Syria Tadjikistan Taiwan Tanzania Thailand Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City State Venezuela Vietnam Virgin Islands (British) Virgin Islands (USA) Wallis and Futuna Islands Western Sahara Yemen Yugoslavia Zambia Zimbabwe
City
Street Address
State (if in USA)
Not in USA Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming
Province (if in Canada)
Not in Canada Alberta British Columbia Manitoba New Brunswick Newfoundland Northwest Territories Nova Scotia Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon
Zip/Postal Code
Time Zone
Not answered (GMT -12:00) Eniwetok, Kwajalein (GMT -11:00) Midway Island, Samoa (GMT -10:00) Hawaii (GMT -9:00) Alaska (GMT -8:00) Pacific Time (US & Canada) (GMT -7:00) Mountain Time (US & Canada) (GMT -6:00) Central Time (US & Canada), Mexico City (GMT -5:00) Eastern Time (US & Canada), Bogota, Lima (GMT -4:00) Atlantic Time (Canada), Caracas, La Paz (GMT -3:30) Newfoundland (GMT -3:00) Brazil, Buenos Aires, Georgetown (GMT -2:00) Mid-Atlantic (GMT -1:00 hour) Azores, Cape Verde Islands (GMT) Western Europe Time, London, Lisbon, Casablanca (GMT +1:00 hour) Brussels, Copenhagen, Madrid, Paris (GMT +2:00) Kaliningrad, South Africa (GMT +3:00) Baghdad, Riyadh, Moscow, St. Petersburg (GMT +3:30) Tehran (GMT +4:00) Abu Dhabi, Muscat, Baku, Tbilisi (GMT +4:30) Kabul (GMT +5:00) Ekaterinburg, Islamabad, Karachi, Tashkent (GMT +5:30) Bombay, Calcutta, Madras, New Delhi (GMT +6:00) Almaty, Dhaka, Colombo (GMT +7:00) Bangkok, Hanoi, Jakarta (GMT +8:00) Beijing, Perth, Singapore, Hong Kong (GMT +9:00) Tokyo, Seoul, Osaka, Sapporo, Yakutsk (GMT +9:30) Adelaide, Darwin (GMT +10:00) Eastern Australia, Guam, Vladivostok (GMT +11:00) Magadan, Solomon Islands, New Caledonia (GMT +12:00) Auckland, Wellington, Fiji, Kamchatka
Conversation Cafe Training Sign-Up
Note: Since hosts will convene a Conversation Cafe, ALL Hosts are required to be
trained in the method. Training involves an informative 90-minute teleconference.
Details with call-in numbers and/or Skype instructions will follow.
Thursday, March 15, NOON PST
Monday, March 19, 3:00PM PST
SKYPE! Wednesday, March 21, 8PM PST (Note: for international hosts)
Thursday, March 22, 5:00PM PST
I will choose my time later.
None of these times work for me.
I am a mentor and will be trained at a different time.
I will honor the Conversation Cafe process and agreements during my conversation.
Your Conversation Cafe Details
If you are not yet decided on the time and place for your conversation, you can change this information later.
What day is your Conversation Cafe?
?? 25 26 27 28 29 30 31
March
2007
What time is your Conversation Cafe?
12:00 12:15 12:30 12:45 1:00 1:15 1:30 1:45 2:00 2:15 2:30 2:45 3:00 3:15 3:30 3:45 4:00 4:15 4:30 4:45 5:00 5:15 5:30 5:45 6:00 6:15 6:30 6:45 7:00 7:15 7:30 7:45 8:00 8:15 8:30 8:45 9:00 9:15 9:30 9:45 10:00 10:15 10:30 10:45 11:00 11:15 11:30 11:45
AM or PM?
Not Answered AM PM
Where is your Conversation Cafe?
Street Address of Your Conversation Cafe
E xperience with Conversation Cafe
I am new to Conversation Cafe!
I have attended, but not hosted, a Conversation Cafe before.
I have hosted a Conversation Cafe before.
__________Check all that apply to you______________
Educator
Business Owner
Cafe Owner
Elected Official
Nonprofit Professional
Student (College)
Student (High School
Student (Other)
Facilitator/Mediator
Community Volunteer
Suggested $25 Donation to Conversation Week 2007*
I will donate $25 to Conversation Week to cover costs. I will donate more than $25 to cover costs of others. I am not currently able to donate $25.
Do you have any comments, suggestions, or ideas for TheTeam [at] ConversationWeek.org?