Chapter Event Worksheet

Please fill out the Chapter Event Worksheet for your upcoming event. Your event plans will be reviewed and a region workforce coordinator will be in contact within 3 business days to go over and finalize details.

Chapter Hosting the Event*

Name of Event

Local Chapter Contact for Registration

Contact Email

Contact Phone

Is Another Chapter Co-Sponsoring the Event?

Yes
No

Co-Sponsoring Chapter

Are any outside organizations sponsoring the event?

If there are outside organizations sponsoring the event we will need the logo of the organization as well as some additional information. You will be contacted if there are further questions.

Yes
No

Date of Event

Event Start Time

:

Event End Time

:

Event or Meeting*

Event type*

Face to Face/In person
Remote/online
Hybrid

What media platform is preferred?

Event Location

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Any additional details on location

Anticipated Attendance

Maximum Attendance

Member Rate

Non-Member Rate

Additional Rate Information

Please include any early bird discounts or additional rate categories

Will there be early bird rates?

Yes
No

Early Bird Deadline

Is lunch included with Conference

Yes
No

If yes, please list if they have choices or if they can indicate if they have dietary restrictions

Are there any additional questions that need to be asked during the registration process?

Yes
No

If yes, please identify questions to be asked

Will training hours be provided?*

Yes
No

If yes, identify the CKC(s) that align with this training*

Event Details

Please be as specific as possible on the details of the event. Include things such as topics covered, presenters, highlights, bios. This information will be used in the creation of flyers and marketing materials.

Additional Resources

NAEYC Membership Brochures
T.E.A.C.H. Early Childhood ® INDIANA
Accreditation Brocures
Non-formal CDA Brochures

** These must be requested at least 4 weeks in advance and will be based on resources available at time of request

How many NAEYC Membership brochures?

How many T.E.A.C.H. Early Childhood ® INDIANA brochures?

How many Accreditation brochures?

How many Non-Formal CDA brochures?

Thank you! We look forward to working with you on your event!

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