Facilitator for Durham Regional Deliberation Form

Thank you for your interest in serving as a facilitator for A Day of Deliberative Dialogue at Duke University on October 13, 2026! Please register by filling out your information below. Once you have registered, Close Up will be in touch with more information about training and the event itself.

Name(Required)

Address(Required)

School Name(Required)

School Email(Required)

Phone(Required)

Personal Email(Required)

Date of Birth(Required)

How did you find out about serving as a facilitator for this program?(Required)

Are you a Close Up Alum?(Required)

Yes - Student

Yes - Teacher

Yes - Former Staff

What is your major or field of interest?(Required)

Are you a member of any civic organizations?(Required)

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