International Partners - Special Events Booking Today's Date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orkshop Partner Full Name First Last Workshop Partner Organizaton(Required) Workshop Partner email(Required) Workshop Partner Full Address(Required) Street Address Address Line 2 City Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands EVENT DETAILSSpecial Event Name(Required) What format is this workshop(Required) Virtual/Streaming (TalkTools will provide the virtual meeting platform) Virtual/Streaming (Workshop Partner will provide the virtual meeting platform) Live/In-Person Workshop Instructor(Required) Vanessa Anderson-Smith Line Avers Tamara Ciciliani Frederique Dumont Colette Ellis Carmenza Herrera Robyn Merkel-Walsh Lori Overland Monica Purdy Renee Roy Hill Risca Solomon Heather Vukelich Rehab Zaytoun Start Date(Required)MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20232024End Date(Required)MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY20232024Start Time(Required) Hours : Minutes AM PM AM/PM End Time(Required) Hours : Minutes AM PM AM/PM Timezone My timezone US Eastern (UTC) timezone IN PERSON OR VIRTUAL: Event Point of Contact (POC)(Required)first name, last name IN PERSON OR VIRTUAL: Event Point of Contact (POC) email(Required) IN-PERSON OR VIRTUAL: Event POC cell, WhatsApp or Facebook Messenger(Required) IN-PERSON: Workshop Venue and Addressname of workshop location, street, city Estimated Number of Participants(Required)Will you need to purchase practicum (hands-on learning supplies) for this workshop(Required) Yes No If this event requires practicum, please list the products/tools neededany practicum kits need to be submitted 30 days or more prior to the event date(s)Will you need to submit a product order for this event(Required)any product orders need to be submitted 30 days or more prior to the event date (s) Yes No If you are submitting a product order for this event, please list the products PLUS THE QUANTITY neededINSTRUCTOR COMPENSATIONHourly Instructor Compensation(Required)as agreed upon in writingTotal Number of Hours for this event(Required)Honorarium/Compensation for this eventIN-PERSON: TRAVEL TERMSInstructor Travel Terms Workshop Partner agrees that TalkTools will arrange airfare for Instructor based on estimates Workshop Partner has provided in this Agreement During the Instructor's stay for this Workshop, Workshop Partner agrees to pay and arrange for hotel accommodations, meals and transportation at reasonable rates TalkTools will bill Workshop Partner for these costs, as part of the final invoice (due to TalkTools within 10 days of the workshop dates) Estimated AirfareWorkshop Partner researches and provides air travel estimateADDITIONAL INFORMATIONProvide any other details we need to be aware of for this special event
