Workshop Booking and Contracting Form - Line Avers Today's Date051234567891011122812345678910111213141516171819202122232425262728293031202220232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Workshop Partner Full Name (First Name and Last Name)(Required) Workshop Partner Organizaton(Required) Workshop Partner email(Required) Workshop Partner Organization Street Address(Required) Workshop Partner Organization City(Required) Workshop Partner Organization Country(Required) Workshop Course(Required) Three Part Treatment Plan for OPT OPT: Assessment and Program Plan Development Other Workshop Instructor(Required) Line Avers = $2800 per day 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 Start Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20222023End Date(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20222023Total Number of Days(Required)Start Time(Required)each day Hours : Minutes AM PM AM/PM End Time(Required)each day Hours : Minutes AM PM AM/PM Workshop Venue Name and Address Workshop Point of Contact (POC)(Required)VIRTUAL OR IN-PERSON: first name, last name Workshop Partner agrees to be responsible for any catering during the workshop Workshop Partner agrees Estimated Number of Participants(Required)TalkTools expects the MAXIMUM number of participants for this workshop to be 60 (sixty) participants. For each participant exceeding this maximum number, the Workshop Partner will pay TalkTools® $40.00 per person for a 2-day workshop and $20.00 per person for a 1-day workshop. Total Honorarium/Speaker Fee for this workshopDeposit AmountDeposit is equal to 25% of the total speaker fee/honorarium for Instructor. Will you need to purchase practicum (hands-on learning supplies) for this workshop(Required) Yes -- Workshop Partner will order practicum for each participant No -- Workshop Partner has the supplies and will assemble the practicum for each participant Practicum/Hands-On Learning Supplies List(Required)PLEASE REVIEW THE PRACTICUM LIST FOR THIS WORKSHOP - https://talktools.com/pages/live-workshop-practicum Workshop Partner has reviewed the practicum list Select the PRACTICUM SKU for this workshop if you are purchasing(Required) [SKU 3801] Three Part Treatment for OPT(Level 1) [SKU 3803] OPT: Assessment and Program Plan Development (Level 2) Other Select the PRACTICUM PRICE for this workshop if you are purchasing(Required) Three Part Treatment for OPT(Level 1) = $8 per participant OPT: Assessment and Program Plan Development (Level 2)= $17 per participant Other = $8 per participant ( (this is a placeholder for the purposes of estimating workshop costs) Estimated Practicum CostsInstructor Travel Terms(Required) 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 Air Travel(Required)Workshop Partner researches and provides air travel estimate. If virtual, leave blankEstimated Total Workshop Costshonorarium+speaker fee+estimated practicum if purchasing+estimated air travel if workshop is in-person
