Domestic (US) Workshop Partner-Private Group [SELF-STUDY] Today's Date MM DD YYYY Workshop Partner Name(Required) First Last Workshop Partner Organizaton(Required) Workshop Partner Organizaton Address(Required)Street, City, State Workshop Partner email(Required) Point of Contact POC (Point of Contact) during the training Point of Contact (POC) cell Confirm the format for this training is on-demand(Required) I confirm that this training is self-study/on-demand Which self-study/on-demand courses will your group be enrolled in?(Required)review self-study course collection: https://talktools.com/collections/opt-self-study-on-demand Start Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20242023End Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20242023Workshop Partner has read the course description and timed agenda for this workshop(Required)See Self-Study courses: https://talktools.com/collections/opt-self-study-on-demand I have the course description and timed agenda for this workshop Estimated Number of Participants(Required)Private Group Base Fee(Required)covers instructor commissions + overhead costs (per person) $2000 Participant Listupload the current attendance list in an Excel sheet. Include First Name, Last Name, email address, cell, full mailing addressAccepted file types: xls, xlsx, csv, Max. file size: 128 MB.Practicum/Hands-On Learning Supplies(Required)Hands-on learning supplies (Practicum) is listed on the course page. TalkTools will individual ship supply kits to each participant I have reviewed the practicum list I agree to share shipping costsTalkTools and Workshop Partner will share shipping costs for practicum (50/50 split) $3 (per person) Estimated Shipping CostsIs TalkTools managing CEUs for this event on behalf of the Workshop Partner? Yes No I agree to the CEU filing fee $5 (per person) Estimated CEU Filing CostsEstimated Total Training Costs