Facilitator Contact Webpage

If you are interested in serving as a meeting facilitator, please fill out this survey. Please also attach an approval letter from your supervisor.

Once it is filled out it this survey will be vetted and you will receive notification if we will be placing your contact information on the ANR Learning & Development. The purpose of this page will be to serve as a contact list for internal personnel (and possibly other UC locations and ANR Partners) can locate a facilitator directly.

✻ = Required

My name: ✻

My email: ✻

I learned facilitation from the following organization(s). ✻

I'm interested in facilitating meetings that are (choose all that apply): ✻

2-3 hours 4-6 hours multiple days ANR only UC Campus Partner organizations

In the past I have facilitated meetings that were (choose all that apply) ✻

2-3 hours 4-6 hours multiple days ANR only UC Campus Partner organizations

If you have facilitated partner organizations, which one(s)? ✻

I rate my level of experience and skill as: ✻

I have little to no experience but would like to partner with an experienced facilitator and assist at a meeting I have experience and skill in facilitating non-contentious meetings I have experience and skill in facilitating contentious meetings

My experience includes consulting with stakeholders and planning the agenda ✻

Yes No

I would be willing to travel from my home office the following distance if travel funds were supplied: ✻

Less than 20 miles Less than 50 miles Less than 100 miles 100+ miles, including flying

My supervisor's name: ✻

My supervisor's email: ✻

Remember to attach an approval letter from your supervisor.

I am willing to have my name and contact information an ANR Learning & Development facilitator web page listing, when it is constructed. ✻

Yes No

Show that you are not a robot by entering this code: XMLZ3 ✻