Letter of Engagement for Speaking

 

Please complete the information below and click SUBMIT when finished.

We will add our signature and email a copy to you. 

Any questions, contact info@highconflictinstitute.com.


Address *
Address
Host contact person *
Host contact person
Phone
Phone
http://
ABOUT THE PROGRAM
Name of Speaker(s)
$
Event Start Date *
Event Start Date
Event End Date
Event End Date
Event start time *
Event start time
Event end time
Event end time
Event location
Event location
Day of Event Contact Cell Phone Number
Day of Event Contact Cell Phone Number
TRAVEL DETAILS
Lodging *
We ask host to cover reasonable lodging costs.
We ask host to cover reasonable meal costs and reimburse HCI
We ask the host to provide or reimburse HCI for transportation i.e. cab, shuttle, rental car etc. to/from airport hotel and venue.
Please provide transportation contact and phone
We ask host to reimburse HCI for reasonable flight costs
MARKETING
Do we have your permission to post general info about your event such as host group name, city, and program title on our website, newsletters, and social media.
MATERIALS
HCI will email PDF materials to host by: *
HCI will email PDF materials to host by:
(Host will reproduce materials for event participants or provide them in accordance with organization preferences).
AUDIO/VISUAL
Host will provide: *
RECORDING
(If the answer is no, please provide information below. Some organizations provide the training via webcast or other recording, but please discuss your needs with us first - thank you).
Training focus is: *
Attendees are mostly (check all that apply) *
If yes, please provide name and shipping address for book shipment
If yes, please provide name and shipping address for book shipment
CANCELLATION
Cancellation by Host:  Cancellation fees are based on full amount of out-of-pocket (airfare, etc.) expenses incurred by HCI. Cancellation by HCI:  A qualified substitute trainer will be provided unless Host prefers to change the date.
SIGNATURE
$
Date *
Date
CHECK: If you are paying by check, USD (U.S. Dollars) must be indicated on the check. Please send to: 7701 E Indian School Rd, Ste. F, Scottsdale, AZ 85251. CREDIT CARD: If you are paying by credit card, we will send a link to the email address you provided above. You can pay securely with your credit card. Please note there is a 2.5% fee for credit cards payments. WIRE TRANSFER: If you are paying by wire transfer, a $16 fee is added. Wire info: Wells Fargo Bank. N.A. 11275 E Via Linda Scottsdale, AZ 85259 USA Phone: +1 480 614 8416 SWIFT code: WFBIUS6S Wire Routing Transit Number: 121000248 Account Number: 2988204034. High Conflict Institute, LLC 7701 E. Indian School Rd., Ste. F Scottsdale, Arizona, 85251, USA
HCI Representative Signature (Will be signed after receipt and emailed back to you.)
THANK YOU! Your event will be confirmed when your deposit is received, unless we've agreed to waive it (for organizations who cannot pay until after the event such as universities).