2019 Convening Registration

Grassroots Convening Registration 2019

Thank you for registering for the Rose Foundation's 2019 Grassroots Convening on October 29, 2019 in Davis, CA!

Registration closes on October 22, 2019.

To be eligible to register, you must be a staff member, volunteer or board member of a California group that has received a grant from the Northern California Environmental Grassroots Fund, the California Wildlands Grassroots Fund, or the Grassroots Training Institute. Current fiscally sponsored projects of the Rose Foundation are also eligible.

Please note: All grantees are warmly welcomed, regardless of when a grant was received. Spanish speakers are encouraged to attend and simultaneous translation will be available! Este evento será traducido simultáneamente de inglés al español.

Fields marked with * are required.

Personal Info

Please enter as XXX-XXX-XXX
Apt, Suite, etc.

Stipends

If you qualify for a mileage stipend and/or hotel stipend, please complete this section.

Travel Stipend

If you would like to receive a travel stipend, what will be your one-way mileage to Davis?
(If you are not sure of the mileage, use Google Maps)

If you are traveling more than 50 miles one-way to attend the convening you are eligible for a mileage stipend as listed below (limited to two per group):

  • $50  If you are 51 – 100 miles (one way) from Davis
  • $75  If you are 101 – 150 miles (one way) from Davis
  • $100  If you are 151 – 200 miles (one way) from Davis
  • $150  If you are 201 – 300 miles (one way) from Davis
  • $200  If you are more than 300 miles (one way) from Davis

Travel stipend checks will be handed out at the conference when you check in.

Hotel Stipend

If traveling over 200 miles one-way, you are eligible for a hotel stipend of $110. If traveling over 300 miles one-way, you are eligible for a hotel stipend of $220. (Limited to two per group. Please only apply if you need a hotel room. You are responsible for making your own hotel reservation and for paying for your room. Hotel stipend checks will be handed out at the conference when you check in.)

Photo and Sound Release

Number of Attendees in Your Group (Each Group Gets TWO Free Tickets)

Each group is eligible for two free tickets to the convening. Additional attendees can register for a nonrefundable fee of $25 each. NOTE: Please submit this form for every individual convening attendee.

Payment for additional attendees can be made by check to: Rose Foundation, 201 4th Street, Suite 102, Oakland, CA 94607. Please put the purpose and attendee name(s) in the memo section.

To pay by credit card, go to Rose Donation Center. Please put the attendee name in the name line of the form.

Tell Us About Your Group

To provide you with the most helpful content and exercises during our gathering, please answer the following questions.

Questions for Messaging and Media Workshop Participants

Note: You only need to answer the questions in this section if you plan on attending the "Messaging and Media" workshop. If you do not plan on attending this workshop, you may leave these questions blank and skip to the "Comments" section.

Comments

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