Assignment DetailsSubject/Topic*Provide a title for the class, meeting, or event.Recurring event?*Only select "Yes" if the event title above will repeat on a daily or weekly basis. If your schedule is more complex than that, such as a multi-day conference, please email the details to us directly (instead of using this form) at email@example.com.YesNoDate of Service* Date Format: MM slash DD slash YYYY Start Date* Date Format: MM slash DD slash YYYY End Date (if known) Date Format: MM slash DD slash YYYY Start Time* : HH MM AM PM End Time* : HH MM AM PM Time Zone*(GMT -10:00) Hawaii(GMT -9:00) Alaska(GMT -8:00) Pacific Time (US & Canada)(GMT -7:00) Mountain Time (US & Canada)(GMT -6:00) Central Time (US & Canada), Mexico City(GMT -5:00) Eastern Time (US & Canada), Bogota, Lima(GMT -4:00) Atlantic Time (Canada), Caracas, La Paz(GMT -3:30) NewfoundlandRepeats Every* Select All Sunday Monday Tuesday Wednesday Thursday Friday Saturday Setting* School/Educational Business/Corporate Nonprofit Conference/Special Event Other Meeting/Event Platform*Tell us how the transcriber and/or consumer will join the event to access the audio & visual content.Zoom Blackboard CollaborateGoogle ClassroomConference call (phone)Transcriber(s) can be located*On-siteRemoteNo preferenceWhat prep materials will be provided, if any?Please answer to the best of your knowledge so we know what to expect in advance, such as PowerPoint slides, textbook, lecture notes, meeting agenda, etc.Contact InformationYour Name*Individual scheduling/coordinating the services First Last Your Phone*Your Email* OrganizationYour RoleService CoordinatorHuman ResourcesEvent CoordinatorParent/ AdvocateConsumer (individual using/accessing the services)SupervisorBilling AddressPlease complete this section if you are a new client. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Consumer Name(s) & Contact InfoIf you would like us to provide connection details in advance to the person(s) who will be accessing/utilizing the services, please provide their name(s) and the best way to reach them.Review Our Terms:*FOR REMOTE TRANSCRIPTION: • Live audio will be transmitted to the remote transcriber via Skype, Zoom, or other VOIP. • TypeWell can provide a reader device and/or digital microphone upon request. • The real‐time transcript can be viewed in a web browser by one or more of the Client’s viewers, on their own device(s). TypeWell will provide a unique transcript URL in advance. • After the event is over, the rough‐edited transcript will be emailed to Client in .docx format within 24 hours (or sooner, if requested). SCHEDULING & PAYMENT TERMS: • If you are a new client, pricing will be confirmed with you ASAP. • Meetings over 90 minutes in duration may need a team if a break is not built-in. • Highly technical assignments may require prep time and/or a team, regardless of duration, to ensure quality of service. • 1‐hour minimum per assignment, charged in 15‐minute increments. • Client will not be billed for cancellations received at least 24 hours in advance by email (firstname.lastname@example.org) or phone/SMS (844‐897‐3935). • There is no extra charge for technical assistance, travel time, or other administrative time unless agreed to by both parties in writing. • TypeWell will submit biweekly invoices to Client by e‐mail. Payments can be made by check or credit card, due within thirty (30) days from the date of receipt of the invoice. • Late payments shall be subject to late penalty fees of 3% per month from the invoice due date until the amount is paid. I have reviewed and agree to the Scheduling & Payment Terms.Any additional questions or details you'd like to share with us?