Category Archives: Forms

ESS Interview Info (part 1)

This is the first of two web pages you’ll need to visit to give us the right info about your upcoming Expert Speaker Conversation. You’ll be automatically directed to the second page.

We need this information before we can post and publicize your recording.

Please remember, this call is scheduled for one hour.


If you have a photo or additional handouts that you think of later, please send them to webmaster@adhdcoaches.org

ESS Speaker Agreement (part 2)

Please fill out the format the bottom of this agreement so we know you’re ready to have your Expert Speaker Series interview for ACO member coaches.

ADDITIONALLY the signer recognizes and agrees that a copy of this form is acceptable and binding and will serve as an original in any instance. Additionally, the signer recognizes and agrees that should this form be emailed instead of posted or FAXed, the header information from their email address of record is acceptable and binding and will serve as a valid signature.

This is a letter of agreement between the undersigned speaker and the ADHD Coaches Organization (also known as ACO) and represented in this agreement by Joyce Kubik, ACO Programs Chair.

The speaker agrees to:

  1. Provide the one hour talk listed below.
  2. Notify the ACO immediately in the event that an emergency should prevent the speaker from meeting the obligation as a speaker.
  3. Authorize the ACO to use his/her name, likeness, photograph and/or biographical data in connection with the use and promotion of the Expert Speakers’ Series.
  4. Authorize the ACO to audio record this interview presentation.

The ACO agrees to provide

  1. Bridge line to conduct and record the interview
  2. Publicity to the membership by
    1. announcements in Circle (the monthly newsletter of the ACO),
    2. in the members list serve and
    3. on the website here: www.adhdcoaches.org/members/?cat=3
    4. MP3 recording of the teleclass for use by the speaker and also for download by members in good standing of the ACO.
    5. Instructions on how to download a copy of the recorded teleclass when it is available, generally within about one week.
    6. Notification to the membership when the recordings are available which will include the program name, speaker’s name and a link to the page from which the recording can be downloaded.

    The speaker further agrees the following:

    • I warrant and represent that, to the best of my knowledge, nothing in my presentation violates any proprietary or personal rights of others (including without limitation, copyright or privacy rights); is factually accurate, and contains nothing libelous or otherwise unlawful.
    • I am aware that I am not entitled to any salary or payment for services.
    • I agree to indemnify the ACO and/or hold the ACO harmless in the event that the representations made by myself, either during or before said program(s) that is knowingly false, misleading or a departure from a generally accepted industry practice. I shall indemnify and hold the ACO harmless in the event any litigation arises from the content provided by the Speaker in the program(s) referenced herein.
    • I understand that the name ACO, its likeness, logo, materials, content are the exclusive intellectual property of the ACO and may only be used for the exclusive purpose of fulfilling its obligations pursuant to this agreement.
    • I understand that the database of participants, and the information contained therein is the exclusive property of the ACO and shall not be used, accessed, shared, leased, licensed or sold to any other entity, without the expressed written consent of the ACO.

    I hereby understand and agree to the above conditions as listed.

    The signer recognizes and agrees that a copy of this form is acceptable and binding and will serve as an original in any instance. The date of the submission will be captured by the software in place. Additionally, the signer recognizes and agrees that should this form be emailed instead of posted or FAXed, the header information from their email address of record is acceptable and binding and will serve as a valid signature.

ACCE instructor information form (part 1)

Please fill out this form so we have the right info about you and your class for our publicity.
Thanks

This is the first of TWO web pages you’ll complete for this class

When you submit this form, you will jump to a copy of our on line agreement/contract regarding your teaching of an ACCE class for the ACO.

You must fill out the form at the bottom and send that in.
You’ll get a copy of the agreement in a confirmation email.

ACCE instructor agreement (part 2)

Please read this agreement and fill out the format the bottom so we know you’re ready to give your ACCE class to paying participants.

When you submit this form, you will receive an email confirmation of your answers and this complete form. Thank you.

PLEASE NOTE: The signer recognizes and agrees that a copy of this agreement is acceptable and binding and will serve as an original in any instance. Additionally, the signer recognizes and agrees that should this form be emailed instead of posted or FAXed, the header information from their email address of record is acceptable and binding and will serve as a valid signature.

This is a letter of agreement between the undersigned speaker and the ADHD Coaches Organization (also known as ACO) and represented in this agreement by Joyce Kubik, ACO Programs Chair.

The speaker agrees to:

  1. Provide the talk listed below on the dates listed below.
  2. Notify the ACO immediately in the event that an emergency should prevent the speaker from meeting the obligation as a speaker.
  3. Authorize the ACO to use his/her name, likeness, photograph and/or biographical data in connection with the use and promotion of the ACCE program.
  4. Authorize the ACO to audio record this teleclass presentation.
  5. Provide, not less than 30 days before the presentation, the following information:
    1. Short bio of the speaker: not to exceed 75 words to be used on the website and as an introduction to the session
    2. Short description of the talk: not to exceed 100 words
    3. Any books to be promoted must include the full title, author information and a direct link to its associated page in amazon.com

The ACO agrees to provide

  1. Bridge line to conduct and record the teleclass
  2. Publicity to the membership by
    1. announcements in Circle (the monthly newsletter of the ACO),
    2. in the members list serve and
    3. on the website
    4. MP3 recording of the teleclass for use by the speaker and also for download by class participants.
    5. Instructions on how to download a copy of the recorded teleclass when it is available, generally within about one week.

    The speaker further agrees the following:

    • I warrant and represent that, to the best of my knowledge, nothing in my presentation violates any proprietary or personal rights of others (including without limitation, copyright or privacy rights); is factually accurate, and contains nothing libelous or otherwise unlawful.
    • I am aware that I will be paid 75% of the total income derived from this class, to be paid in two installments. In addition, if I pay a fee to the ICF for CEU credits, the ACO will reimburse me for that fee.
    • I agree to indemnify the ACO and/or hold the ACO harmless in the event that the representations made by myself, either during or before said program(s) that is knowingly false, misleading or a departure from a generally accepted industry practice. I shall indemnify and hold the ACO harmless in the event any litigation arises from the content provided by the Speaker in the program(s) referenced herein.
    • I understand that the name ACO, its likeness, logo, materials, content are the exclusive intellectual property of the ACO and may only be used for the exclusive purpose of fulfilling its obligations pursuant to this agreement.
    • I understand that the database of participants, and the information contained therein is the exclusive property of the ACO and shall not be used, accessed, shared, leased, licensed or sold to any other entity, without the expressed written consent of the ACO.

    I hereby understand and agree to the above conditions as listed.

    The signer recognizes and agrees that a copy of this form is acceptable and binding and will serve as an original in any instance. The date of the submission will be captured by the software in place. Additionally, the signer recognizes and agrees that should this form be emailed instead of posted or FAXed, the header information from their email address of record is acceptable and binding and will serve as a valid signature.

Remove my membership

If you choose leave the ACO: And we hope you won’t

Please fill out and send this form and we’ll stop the payments.  If it’s less than 15 days since you were charged, we’ll happily refund your last payment.