Please send this contract via fax (603-472-3063), e-mail (firstname.lastname@example.org), or through the mail (Character Development Foundation, PO Box 4783, Manchester NH 03108). To register from this site, ……..
Name of School:__________________________________________________
Designated Official at School:________________________________________
Title of Official:____________________________________________________
Address of School:__________________________________________________
Address of Designated Official (if different from school):____________________
Telephone number of School:__________________________________________
Telephone number of Designated Official (if different from school):____________
Number to call in an emergency if the School cannot be reached:_______________
Directions to School:__________________________________________________
Number and Name of Workshop/Presentation desired:
Date requested:_____________________ Time requested:_____________ to _________
Speaker requested (optional):________________________________________________
When there is a specific request, CDF tries to fill it. If the requested speaker is unable to make that date, or if there is a last minute emergency, another presenter will serve as replacement. If this is not acceptable, be note here:_______________________
There will be approximately __________ (#) participants.
Travel costs are .36 per mile. _________ Total cost (for 40 people or less) ________
Per hour: $250 doctoral level; $150 master’s level; $75 consulting
Photocopying will be provided by ____________________________.
Audio-visual equipment (overhead, VCR, slide) will be provided by ________________.
We understand that the presenter needs to be able to get into the room approximately one hour before the scheduled workshop. ______
School Representative Date
CDF Representative Signature Date
(603)472-3063 telephone and facsimile; Mail to CDF, PO 4783 Manchester NH 03108
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