Host Site Agreement

PROGRAM HOST SITE AGREEMENT
This agreement indicates that Cents Ability will earnstly recruit volunteers to teach a financial literacy workshop at the following site on the dates listed below. Please carefully read all terms of the agreement before submitting.

Please note that we ask for at least 2 weeks notice for date of first workshop from date this form is submitted for virtual workshops, and at least 3 weeks notice for in-person workshop requests.

*Please be sure to include the exact dates and times which you would like to host our workshops*
Name of Site:
Site Coordinator: *Point of contact who will be at workshop**

First NameLast Name
Phone #:*
E-mail:*
Would you prefer to have virtual workshops or in-person workshops?*

VirtualIn-person
Location where workshop will be held (if in-person)*

Street Address

Room Number

CityState

Zip Code
Directions (optional)
If your site is sometimes difficult to find, please provide specific instructions for our volunteers in the box above
Approximate number of students who will be participating*
Age range of students who will be participating*
ex: 16-18
Modules covered during workshops (each module can be covered in a 1 hour class)

Intro and Goal SettingBudgetingSavings and BankingCreditInvestmentsStock MarketCollege CentsYour Financial LifeCareers in Finance
Preferred Start Date (At least 3-4 weeks from date of form submission for in-person, 2 weeks for virtual)*

MonthDayYear
Date
Please provide the exact dates and times you would like to have our workshops
Workshop dates:
Workshop times:
My site is equipped with a computer and projector for the workshop (if in-person)*

YesNo
Please tell us about the students who will be participating and their prior knowledge of financial topics
What made you choose to have Cents Ability Volunteers teach financial literacy to your students?
In the case I am unable to be reached, Cents Ability may contact the person below concerning this financial literacy workshop:
Alternative Contact: Name/Title
Alternative Contact Phone #:
Alternative Contact E-mail:
*PLEASE NOTE: this agreement does not confirm a match with our volunteers, all workshops are provided to the terms agreed upon above with the limitation to volunteer avaliablity.
Unauthorized Use Clause

The undersigned agrees that neither the signer or the host site will alter, disseminate, reproduce, or use the modules in an unauthorized way, without the written permission of Cents Ability, and will only use the modules for the specific dates set forth and requested in this agreement. Signer acknowledges that a violation of this clause will result in the host site forfeiting their status as a free partner in Cents Ability's program and agrees to pay $5,000 for each time the modules are used without permission, in accordance with our base fees for a private partner.
Signature*

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PROGRAM HOST SITE AGREEMENT