Disability:IN Engagement Request Form

Thank you for your interest in a Disability Equality Index Deep Dive, Course Catalog Training, or Guest Speaker from Disability:IN. Please see below for descriptions and pricing based on partnership level.

Regardless of whether this is included in your corporate partnership, or you are being invoiced, your company is responsible for fulfilling all accommodation requests including ASL and CART, for whoever on your team will join these events, either in-person or virtually.

Are you a Corporate Partner?

YesNo

Company Name

Company Name:

First Name:

Last Name:

Title:

Email (please use your corporate email):

Current Partnership Level

Current Partnership Level Hidden

Inclusion Works Membership

Engagement Opportunity

Disability Equality Index Deep Dive ($5,000, $6,000 for a multi-market analysis)- a one-hour virtual session with a disability inclusion subject matter expert featuring company-specific, customized insights and recommendations for advancing your disability inclusion strategy based upon your Disability Equality Index results.Disability Inclusion Training from Disability:IN Course Catalog ($5,000)- a one-hour virtual session with a disability inclusion subject matter expert covering a topic of your choice from our Course Catalog with time for Q&A; includes one 30-minute prep session.Disability:IN Guest Speaker ($2,000 for virtual or $2,500 plus travel and expenses for in-person)— Invitation for a member of the Disability:IN team to join a fireside chat or panel discussion; background materials and PowerPoint presentations not provided by Disability:IN.

Engagement Opportunity

Disability Equality Index Deep Dive (included in partnership)- a one-hour virtual session with a disability inclusion subject matter expert featuring company-specific, customized insights and recommendations for advancing your disability inclusion strategy based upon your Disability Equality Index results.Disability Inclusion Training from Disability:IN Course Catalog (included in partnership)- a one-hour virtual session with a disability inclusion subject matter expert covering a topic of your choice from our Course Catalog with time for Q&A; includes one 30-minute prep session.Disability:IN Guest Speaker (included in partnership plus travel and expenses for in-person)— Invitation for a member of the Disability:IN team to join a fireside chat or panel discussion; background materials and PowerPoint presentations not provided by Disability:IN.

Engagement Opportunity

Disability Equality Index Deep Dive (included in partnership)- a one-hour virtual session with a disability inclusion subject matter expert featuring company-specific, customized insights and recommendations for advancing your disability inclusion strategy based upon your Disability Equality Index results.Disability Inclusion Training from Disability:IN Course Catalog ($5,000)- a one-hour virtual session with a disability inclusion subject matter expert covering a topic of your choice from our Course Catalog with time for Q&A; includes one 30-minute prep session.Disability:IN Guest Speaker (one included in partnership, for additional: $2,000 for virtual or $2,500 plus travel and expenses for in-person)— Invitation for a member of the Disability:IN team to join a fireside chat or panel discussion; background materials and PowerPoint presentations not provided by Disability:IN.

Engagement Opportunity

Disability Equality Index Deep Dive (included in partnership)- a one-hour virtual session with a disability inclusion subject matter expert featuring company-specific, customized insights and recommendations for advancing your disability inclusion strategy based upon your Disability Equality Index results.Disability Inclusion Training from Disability:IN Course Catalog ($5,000)- a one-hour virtual session with a disability inclusion subject matter expert covering a topic of your choice from our Course Catalog with time for Q&A; includes one 30-minute prep session.Disability:IN Guest Speaker ($2,000 for virtual or $2,500 plus travel and expenses for in-person)— Invitation for a member of the Disability:IN team to join a fireside chat or panel discussion; background materials and PowerPoint presentations not provided by Disability:IN.

Inclusion Works Engagement Opportunity

Disability Equality Index Deep Dive (included in partnership)- a one-hour virtual session with a disability inclusion subject matter expert featuring company-specific, customized insights and recommendations for advancing your disability inclusion strategy based upon your Disability Equality Index results.Disability Inclusion Training from Disability:IN Course Catalog (included in partnership)- a one-hour virtual session with a disability inclusion subject matter expert covering a topic of your choice from our Course Catalog with time for Q&A; includes one 30-minute prep session.Disability:IN Guest Speaker (included in partnership plus travel and expenses for in-person)— Invitation for a member of the Disability:IN team to join a fireside chat or panel discussion; background materials and PowerPoint presentations not provided by Disability:IN.

Select a Course Catalog Topic

Preferred Date/Time 1 (in Eastern time)

Preferred Date/Time 2 (in Eastern time)

Preferred Date/Time 3 (in Eastern time)

Is your speaking event virtual or in-person?

VirtualIn-person

Event Virtual Platform

Event Location

Will this event be recorded?

YesNo

If the event is recorded, where will it be shared?

Anticipated number of attendees

Anticipated makeup of attendees (internal vs. external)

List of other speakers

Event Objective

Desired Topic

Desired Format (Panel, Q&A, Keynote, Etc.)

If this event is in-person, will your company be able to cover travel, hotel, and meal costs for the speaker?

Which Virtual Platform would you like to use?

Disability:IN Staff Member who sent you the form

Please let us know if you have any questions or comments!