Request a Workshop at your State Association State Association Speaker Request Form Please complete this form to request a Cost Collection Education workshop at your State EMS or Ambulance Association. Name First Last Email PhoneName of Group or Organization*Requested length of Cost Collection Education Education:*Full-day workshop (8 hours)Half-day workshop (4 hours)90 minute presentationOther (please indicate in comment field)Are you willing to cover the travel expenses of our speakers?*Are you willing to pay a speaking fee?*How much of an honorarium would you be willing to pay the AAA to support Cost Collection Education?How much money will you charge workshop attendees?DatesIf you have a specific set of dates (or even a general range), let us know here.LocationIf you'd like someone in person, where?Please let us know if you have any additional comments or questions
