Program - Workshop Interpreter Information Submission Form - Not Local - Arkansas Registry of Interpreters for the Deaf

"*" indicates required fields

Presenter Contact Information

Legal Name*

First Last

Pronouns*

What are your preferred pronoun(s)?*

Do you have a preferred name (Different than above)?*

Yes

Preferred Name (Different than above)*

First Middle Last Suffix

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Billing and Mailing addresses are*

Same

Different

Billiing Address*

Street Address Address Line 2 City State ZIP Code

Email*

Enter Email Confirm Email

Preferred Phone Options:*

VP Number

Mobile - Text Only

Voice Phone (cell, landline, VoIP)

VP Number*

Mobile - Text Only Number*

Voice Phone Number*

Workshop Processing Checklist

Please select that you have all of the items required to submit your Workshop Processing before continuing to the next page. You will be asked to provide/upload all of the documentation before you can process payment.

Workshop Processing - Please check all of the items you currently have. You must have all of this information before continuing to the next page.*

If you have any question or concerns gathering all of the required documentation to process your request please contact pdc@arkansasrid.org.

Completed RID Instructor Form

Presenter Bio

Presenter Resume/CV

Completed W-9 Form

The above required forms can be found at the following links

Link for fillable RID Instructor form (Please copy and paste link into web browser **This will download the form to your computer to fill out**): https://drive.google.com/uc?export=download&id=1_19J6ijruH2KFnSq59FyIw8JwNIzAF32

Link for IRS W-9 Form (Please copy and paste link into web browser): https://www.irs.gov/pub/irs-pdf/fw9.pdf

I understand I will not be able to complete this form unless I have all of the above documentation.*

I understand.

Where will you be presenting?*

Virtually (Zoom)

In-Person (Traveling to Arkansas)

Will you need hotel/lodging accommodations?*

No, I reside in Arkansas and no not require lodging.

No, I will be traveling to and from the Workshop location in the same day.

Yes, I will be needing Hotel/Lodging accommodations

Do you have any dietary restrictions?*

No dietary restrictions

Vegetarian

Vegan

Gluten Free

What language will the workshop be presented in?*

Spoken English

ASL

ASL Interpreters will be provided if an accommodation request is submitted.

Would you like a voice interpreter for your presentation?*

No, information presented will be most effective without a voice interpreter.

No, only provide a voice interpreter if someone requests an accommodation.

Yes, I would like a voice interpreter for my presentation.

Workshop Processing - RID Instructor form*

Drop files here or

Max. file size: 450 MB.

Workshop Processing - Presenter Bio*

Drop files here or

Max. file size: 450 MB.

Workshop Processing - Presenter Resume*

Drop files here or

Max. file size: 450 MB.

Completed W-9 Form*

Drop files here or

Max. file size: 450 MB.

Payment Information

How would you like to be paid after you present?*

Check (Mailed to you through Bank of America Bill Pay - Expect 1-2 weeks after submitted)

Zelle (Almost instant once submitted - Can create an account or use it through your bank)

Where would you like your check sent?*

Address listed on W-9

Other

Other Check Address*

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

Have you used Zelle before/have an account?*

Yes, I have an account

No, I don't have an account and need assistance in setting this up.

No, I don't have an account and would like you to send me a message after presenting to make an account. (This may delay processing time)

Does your Bank offer Zelle?*

Yes, my bank utilizes Zelle.

Unsure if my bank offers Zelle.

No, my bank does not offer Zelle.

If your bank uses Zelle and need assistance in connecting your account please copy and paste the following link into your browser for guidance. https://www.zellepay.com/get-started

If you are unsure if your bank uses Zelle you can copy and paste the following link into your browser and search for your bank. If your bank is listed select your bank account and follow the connection instructions. If your bank does not utilize Zelle please select "No, my bank does not offer Zelle" for instructions on how to create your account. https://www.zellepay.com/get-started

If your Bank does not offer Zelle you can create an account by downloading the Zelle app on your phone. Once you download the app on the bottom of the homepage you will see "Don't have an account? Sign up" Select Sign up and follow the instructions.

Have you successfully set up your Zelle Account?*

Yes, I set up my account.

No, I need additional assistance

If you need additional assistance setting up your Zelle account please email president@arkansasrid.org

What is your Zelle account linked to?*

My Email Address

My Phone Number

Email*

Enter Email Confirm Email

Phone*

Travel Info

How would you like to travel to Arkansas?*

Drive

Fly

I reside within Arkansas and no mileage reimbursement is necessary.

Other

Mileage will be reimbursed at the current federal rate up to $500. It will be calculated from starting position (home) to agreed upon location in Arkansas and back (home).

Where will your starting location be?*

My Billing Address (Listed previously)

My Mailing Address (Listed previously)

Other

Other Address*

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

Flights (roundtrip) will be covered up to $500. You can have the option to allow us to reserve your flights for you or you can reserve your own flights and submit all receipts prior to your workshop date(s) to treasurer@arkansasrid.org

How would you like to book your flight?*

I will book myself and submit receipts to treasurer@arkansasrid.org prior to my workshop date.

I will allow ARID to book my flight for me.

What is the closest airport to you or do you have a preferred airport you would like to leave from?*

Please list as many as possible to increase possibilities of us able to meet all of your preferences for departure time and airline.

Do you have a preferred Airline (Airlines listed are those that fly to Arkansas)*

Airline choice will be considered but cannot be guaranteed based on price and availability.

Allegiant

American Airlines

Delta

Southwest

United

Frontier

If applicable, please enter your frequent flyer/rewards number associated with that airline?

If applicable, please enter your TSA pre-check number.

Please enter your name as it appears on your Government issued ID. Must match ID for TSA security purposes.*

First Middle Last Suffix

Please enter your Birthdate.*

Airlines require your birthdate to purchase a ticket.

Month

Day

Year

Do you have a preference for a departure time when you fly from Home to Arkansas? (Select all that apply)*

We will do our best to accommodate your preferences but cannot be guaranteed to to prices and availability.

First Flight of the day (Earliest)

6am-8am

8am-10am

10am-12pm

12pm-2pm

2pm-4pm

4pm-6pm

Last flight of day (possibility of Red-Eye)

Do you have a preference for a departure time when you fly from Arkansas back home? (Select all that apply)*

We will do our best to accommodate your preferences but cannot be guaranteed to to prices and availability.

First Flight of the day (Earliest)

6am-8am

8am-10am

10am-12pm

12pm-2pm

2pm-4pm

4pm-6pm

Last flight of day (possibility of Red-Eye)

If applicable, Do you have a seat preference on the plane? (Select all that apply)*

N/A

No preference

Window Seat

Middle Seat

Aisle Seat

I am ok with an exit row seat

Travel - Other*

Other travel arrangements can be made by contacting president@arkansasrid.org

Based of Arrival and Departure dates what dates would you need a hotel room?*

Night before workshop only

Night of workshop only

Night before and night of workshop

Do you have a preferred Hotel Chain? (Select all that Apply)*

No Preference

Best Western

Hilton

Choice Hotels

Hyatt

Marriott

Wyndham Hotels

IHG

Other

Other Hotel*

Do you have a Hotel Rewards # (Please Identify what hotel it goes with for example: IHG-789456132, Hilton-564857654, etc.)

This field is for validation purposes and should be left unchanged.

Program – Workshop Interpreter Information Submission Form – Not Local

Presenter Contact Information

Workshop Processing Checklist

Payment Information

Travel Info

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