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

If needed, one additional contact can be specified below. Please provide email for this contact.

*note that all correspondence will always go to the chapter president however if this specific event needs an additional contact (1) we will add them into any communications for this event only.

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

:

Time Zone

ET
CT

Event or Meeting*

Event type*

Live/In person
Hybrid: Live audience and online viewing
Semi-Live: Prerecorded speakers with live Q&A with the speaker
On Demand: Prerecorded speakers available for play back at attendee convenience and speaker discretion
Virtual

Please note that all Hybrid, Semi-Live, and On Demand preferences should give as much advanced notice as possible. Up to 3 months notice is ideal. INAEYC may not be able to grant one of these options if not enough advanced notice is given.

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

Please note that Early Bird rates are intended to drive urgency to an event and will only run up to 30 days before the event start.

Early Bird Rate

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.

Does this event require an Insurance certificate?

Yes
No

Please give name and address of venue*

This address and name could differ from the physical address and name.

Does this event require a contract? Venue or speaker

Yes
No

Upload copy of contract here*

Max. file size: 20 MB.

*This contract will be reviewed and signed by INAEYC Executive Director and will be returned once approved.

Additional Resources

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

** 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!