Forum Moderator Summary Form

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The Road to Recovery
Making Choices for Your Community
Community Forum Summary

This form is to be competed by forum moderators once the forum is complete. Please complete this online form or download and complete, and return your post forum questionnares to Southern Growth Policies Board, Attn: Forum Results, P.O. Box 12293, RTP, NC 27709. Your response by April 1 , 2010 will help ensure that your community's feedback is included in Southern Growth's research and 2010 Report on the Future of the South.

Moderator Contact Information:

Prefix

(Dr., Mr., Ms., etc.)

First Name*

Middle
Initial

Last Name*

Suffix

(Jr., Sr., MBA, CEcD, etc.)

Title/Position:
Dept./Division:
Company/ Organization:*
Address:*

City:*

State:* Zip:*

Phone:*
( ) -

FAX:
( ) -

E-Mail:*

Date of Forum:*

No. of Participants:*

Forum City Location:*

State:*

1. What key thoughts about economic recovery emerged from the discussion?*

2. Was there a shared sense of the future direction the community should take? What was it?*

3. What were the areas of disagreement, if any?*

4. Did the group identify possible actions or next steps?* Please describe.

5. What unique information came out of the forum that our leaders need to know?*

*Fields must be filled out.

Questions? Contact Paula Baker, Southern Growth Policies Board.

On submit, you should be directed to a Thank You page confirming the completion of your registration. Within a few minutes to a few hours, you should also receive a confirming email containing the form's content. If you do not receive this email, please contact Connie Hansen immediately.

Southern Growth Policies Board, P.O. Box 12293, Research Triangle Park, NC 27709
Phone: (919) 941-5145, Fax: (919) 941-5594, Email: info@southern.org