CBP La Junta Workshop

Your Information

First name

Last Name

Email

example@example.com

Phone Number

Organization/Municipality

Position / Role

Attendance

Will you attend?

How did you hear about this workshop?

Dietary restrictions or accessibility needs

Are others from your organization also attending?

Colleague 1 Name + Title

Colleague 1 Email

Colleague 2 Name + Title

Colleague 2 Email

Colleague 3 Name + Title

Colleague 3 Email

Brownfields Site Interest & Focus Areas

Do you have a brownfield site you'd like to discuss at the workshop?

How many sites?

Site 1 Name, Address, Previous Use, and Known Environmental Concerns

Site 1 Assessment Status

Site 2 Name, Address, Previous Use, and Known Environmental Concerns

Site 2 Assessment Status

Site 3 Name, Address, Previous Use, and Known Environmental Concerns

Site 3 Assessment Status

Would you like a CBP staff site visit before or after the workshop?

Which topics are most relevant to you?

Additional notes or questions

Email Consent

A confirmation email will be sent to the address you provided.
Questions? Contact info@cobrownfieldspartnership.org.