We don't have this form working yet. So don't try to use it. Sure, it looks pretty, but there's no guts to make it tick.

Name *
Name
Phone
Phone
Program Type
First Date of Event *
First Date of Event
Please mark the date you facilitated.
Our traditional stipend is $200 per day. How many days did you facilitate. These do not include travel days.
Days of Facilitation X $200
$
How many miles did you travel? Include the total round trip.
Miles X .32 cents per mile
$
$