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* 1. I am registering the following type of program:

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* 2. Please provide your name and contact information

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* 3. Have you completed the training to be a host and/or facilitator of the program

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* 4. Please provide the list of the other trained facilitators for this program.

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* 5. Will the program be conducted at your location?

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* 6. Please provide the estimated start date of your program.

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* 7. How will this program be conducted?

DESCRIPTION OF MATERIALS and PRICING (as of 1/2020)

ONLY Program Materials include: event posting on EEMinds website, EEMinds participant registration management, EEMinds emails/reminders to participants, communication to EEMinds community and social media about the program, participant handbooks, Family Golden Rules, participant certificates, I Am The Parent stickers, and participant feedback survey link and results
  • 10 participants with ONLY program materials = $249+S/H
  • 15 participants with ONLY program materials = $375+S/H

COMPLETE Program Kit includes:  event posting on EEMinds website, EEMinds participant registration management, EEMinds emails/reminders to participants, communication to EEMinds community and social media about the program,  participant handbooks, Family Golden Rules, participant certificates, I Am The Parent stickers, participant feedback survey link and results, and program supplies such as: name badges, sign-in sheets, journals (if applicable), pens, highlighters, post-it notes, kleenex tissues, markers, masking tape, and candy.

  • 10 participants with COMPLETE program kit = $499+S/H
  • 15 participants with COMPLETE program kit = $750+S/H

NOTES
  • The minimum order is for 10 program participants.
  • Only one type of program material can be ordered for a program.
  • Payment must be received prior to shipping of program materials; make sure there is sufficient time to process payments through your local procurement groups/organizations.
  • Program materials will be shipped at least 1 week prior to the program date to the Program Contact Name and the shipping address registered with the submission of this form.
  • There are no refunds once an order is processed, printed, and fulfilled.

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* 8. Please select the type of your materials order

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* 9. Please select the size of your materials order

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* 10. Based on your materials order, what is your estimated price for your materials?

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* 11. Have you already been in contact with EEMinds about your program?

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* 12. Are you expecting EEMinds to provide sponsorship funding or program facilitators for your program?

Thank you for registering your program. A person from EEMinds will be in contact within the next 3 business days to confirm this information and to collect payment for the materials order. If you have any questions or require further assistance, please contact us at info@eeminds.org. Many thanks!

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