Consultant & Trainer Intake Form

Date*

Today's date.

Name of Individual Providing Service*

This form is for individuals. Companies are listed in the Marketplace.

Company

Name of your company or organization, if applicable.

Individual Picture

Specifications: JPG or PNG format, max size 1MB, best dimensions 400 x 400px (5" x 5") or smaller

Accepted file types: jpg, jpeg, png, gif.

Logo

Specifications: JPG or PNG format, max size 1MB, best dimensions 400 x 400px (5" x 5") or smaller

Accepted file types: jpg, jpeg, png, gif.

Website

Address

City State / Province / Region Country

Email*

Phone

Descriptive Heading or Tagline*

This will be placed on website search results, along with the summary below.

Summary*

Provide a short, descriptive summary of your services. This will display on the website search results along with your name and tagline.

Description of Topics and Details*

Provide a complete description of your services here.

Specifications or Bio

Cost of Product (if applicable)

Cost Per Day

Typical cost per day if applicable, excluding travel and expenses.

Product or Service Type*

Consultant
Interim
Other Offering
Trainer

Area*

Select the areas for which you provide services.

Reference #1

Please provide three references--ACCS members if possible--for schools to contact. Include: 1) name, 2) email address and/or phone number, and 3) a brief description of your relationship/services provided.

Reference #2

Reference #3

For Consultants and Trainers