Innovator for a Day Application Form

Submitted by mike brcic on August 10, 2009 - 11:30am

Your Name: *

E-mail address: *

Phone number:

Organization/Project name: *

Organization/Project mission: *

tell us in 1-2 sentences about your organization/project and why you do what you do

Which Location would you prefer?: *

CSI Spadina @ 215 Spadina Ave or CSI Annex @ 720 Bathurst St

Preferred dates for your Desk for a Day

Please select a date for your Desk for a Day, along with a backup in case your 1st selection is not available. Please note that the program is available on Wednesdays and Thursdays only (consult a calendar when entering dates). PLEASE PROVIDE TWO WEEKS NOTICE SO WE HAVE TIME TO ACCOMODATE YOUR REQUEST.

2nd choice: *

1st choice: *

How did you hear about us?: *

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Innovator for a Day Application Form