EPA RLF Workshop | Portland ME

Portland, Maine EPA RLF Workshop Registration Form

Please fill out this form to register for the EPA RLF Workshop presented by Grow America and ICMA.
Full Name to Appear on Badge*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Organization/Company to Appear on Badge*
Job Title to Appear on Badge*
Organization Address*

Street Address

Street Address Line 2

CityState

Zip Code
Tell us more about your organization. Are you from one of the following:*

Current EPA RLF GranteeProspective EPA RLF GranteeFormer EPA RLF Grantee (post-grant close-out)EPATechnical Assistance to Brownfields (TAB) ProviderOther
Describe your experience with operating EPA RLF programs:*

No experience (What is a brownfield?)Basic Awareness (familiar with the EPA RLF program, but have not been directly involved before)Indirect Experience (supported RLF projects or teams, but not managed projects)Extensive Experience (led multiple projects, administered funds, secured supplemental funding awards)Other
Do you have any specific topics or questions you would like to explore at the convening?
Have you booked hotel accommodations at the event hotel or are you planning to?

Event Hotel:
Holiday Inn Portland - By the Bay
88 Spring St., Portland, ME 04101 

CLICK HERE TO BOOK YOUR ROOM BY MONDAY, APRIL 27TH.
*

YesNo
Do you require any special accommodations?
Do you have any food allergies?*

YesNo
Please describe your food allergy.
Emergency Contact*

First NameLast Name
Emergency Contact Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Are you interested in attending a mobile workshop at the conclusion of the event (mid-afternoon) on Wednesday, April 22nd. By responding yes, we will follow up with additional information and a formal sign-up form in the coming weeks.

YesNoUnsure
Note: As this is a free workshop, we request participants cancel their registration if they are unable to attend as soon as possible. Cancellations must be submitted via email to epa-rlf-tab@growamerica.org. Timely cancellations help ensure that available seats can be offered to others on the waitlist. Because space is limited, participants who do not attend without canceling in advance may limit their opportunities to participate in future EPA RLF TAB workshops or events. If the event is not yet at capacity and a wait list has not been formed, and you can no longer attend, you can request a substitution for another member of your organization or local partner. However, substitutions will not be accepted if the event is at capacity.*

I understand.
Note: Your attendance hereby grants permission to Grow America and the International City/County Management Association (ICMA) to use photographs and/or video recordings of me taken at this event in publications, news releases, online, and in other communications. Please email epa-rlf-tab@growamerica.org with concerns or to opt out.*

I understand.
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Portland, Maine EPA RLF Workshop Registration Form