Extended Workshop Proposal Form

The Game Changer Workshop Proposal Form

Please fill out all fields. Changes cannot be made once the form has been submitted. Please note that only electronic versions submitted via the online form will be accepted. Once you have submitted your proposal you will receive an email confirmation with a copy in your inbox.

Fields marked with an asterisk * are mandatory

Part 1: Workshop Format

WHAT WORKSHOP FORMAT IS REQUESTED? Tick one only*

Interactive Circle
Panel Debate

Part 2: Workshop Coordinator

The workshop coordinator will be the main contact during the entire workshop selection and implementation process. *

NAME*

First Last

PLEASE CONFIRM THAT YOU ARE THE WORKSHOP COORDINATOR*

Yes, I confirm.

YOUR EMAIL ADDRESS*

Enter Email Confirm Email

POSITION*

ORGANISATION*

NATIONALITY*

GENDER*

ATTENDED IACC BEFORE?*

IF YES, WHICH IACC? (Command or CTRL click to choose multiple)

SHORT BIO*

Part 3: Workshop Content

WORKSHOP TITLE (Creative titles are welcome!)*

TO WHICH OF THE FOLLOWING THEMES DOES THIS WORKSHOP BELONG? (Tick 1 box only)*

TO WHICH OF THE FOLLOWING THEMATIC STREAMS DOES THIS WORKSHOP BELONG? (Tick 1 box only)*

Designing the future of the fight against corruption
Defending Good Governance for peace and security
Breaking the global corruption web
Exposing the corrupt, knocking out impunity
Ensuring development with social justice, together
Turning promises into collective action

DESCRIBE YOUR WORKSHOP AND WHAT IS NEW ABOUT IT (please include the aims and objectives)*

BRIEFLY OUTLINE THE CORRUPTION ANGLE (Why is this topic relevant to the fight against corruption)*

WHO ARE YOU DOING THIS FOR?*

WHAT IS THE INVISAGED IMPACT & HOW WILL YOU FOLLOW UP?*

Part 4: Workshop Experts

Please fill in the details of the team you’re planning on building for this workshop.

MODERATOR or FACILITATOR

NAME*

First Last

CONFIRMED PARTICIPATION?*

EMAIL ADDRESS*

POSITION*

ORGANISATION*

NATIONALITY*

GENDER*

ATTENDED IACC BEFORE?*

IF YES, WHICH IACC? (Command or CTRL click to choose multiple)

SHORT BIO*

RAPPORTEUR (Person capturing key insights, messages & action points)

Note! The Rapporteurs workshop report will be published under the author’s name and actively published though various channels.

NAME*

First Last

CONFIRMED PARTICIPATION?*

EMAIL ADDRESS*

POSITION*

ORGANISATION*

NATIONALITY*

GENDER*

HAVE THEY ATTENDED AN IACC BEFORE?*

IF YES, WHICH IACC? (Command or CTRL click to choose multiple)

SHORT BIO*

THROUGH WHAT OTHER CHANNELS WILL THE WORKSHOP REPORT BE PUBLISHED AND PUBLICISED?

EXPERT #1

NAME*

First Last

CONFIRMED PARTICIPATION?*

EMAIL ADDRESS*

POSITION*

ORGANISATION*

NATIONALITY*

GENDER*

ATTENDED IACC BEFORE?*

IF YES, WHICH IACC? (Command or CTRL click to choose multiple)

SHORT BIO*

TOPIC OF DISCUSSION*

EXPERT #2

NAME*

First Last

CONFIRMED PARTICIPATION?*

EMAIL ADDRESS*

POSITION*

ORGANISATION*

NATIONALITY*

GENDER*

ATTENDED IACC BEFORE?*

IF YES, WHICH IACC? (Command or CTRL click to choose multiple)

SHORT BIO*

TOPIC OF DISCUSSION*

EXPERT #3

NAME*

First Last

CONFIRMED PARTICIPATION?*

EMAIL ADDRESS*

POSITION*

ORGANISATION*

NATIONALITY*

GENDER*

ATTENDED IACC BEFORE?*

IF YES, WHICH IACC? (Command or CTRL click to choose multiple)

SHORT BIO*

TOPIC OF DISCUSSION*

EXPERT #4 (optional)

NAME

First Last

CONFIRMED PARTICIPATION?

EMAIL ADDRESS

POSITION

ORGANISATION

NATIONALITY

GENDER

ATTENDED IACC BEFORE?

IF YES, WHICH IACC? (Command or CTRL click to choose multiple)

SHORT BIO

TOPIC OF DISCUSSION

Part 5: Additional Information

COMMENTS or ADDITIONAL INFORMATION

DO YOU WORK WITH TECHNOLOGY OR DATA?

ANTI-CORRUPTION FILM FESTIVAL

Would you be interested in attending an Anti-Corruption Film Festival & Fair Play Music Concert around the IACC days?*

Yes
No

FUNDING SOURCES*

Has this proposal been prepared with all invited participants?*

Yes
No

If not, please specify who has prepared the proposal.