SPEAKER AGREEMENT TEMPLATE (If using this template, delete this line from the agreement, as
well as all other highlighted text and blank rows from the final agreement. Also, if the AACN president,
president-elect, or any board member will be speaking for your event, this contract would NOT be used.
Instead, complete and submit the online Speaker Request Form)
Speaker Agreement
between (name of speaker) (Speaker) and
the (name of chapter) Chapter of the American Association of Critical-Care Nurses
(Chapter)
Event / Course
Title:
Dates:
(Month/Day/Year)
Location:
(Name of facility/hotel)
Class Format:
(lecture, case study, etc.)
Sessions:
(number of hours and number of days)
Class Days:
Example:
Full-day workshop/seminar
Suggested registration 7:00 a.m. - 7:30 a.m.
Suggested class from 7:30 a.m. - 4:30 p.m.
One hour for lunch
One 15-minute break in the morning and one in the afternoon
Total – 7.5 hours of lecture each day – 9 contact hours each day
Speaker Name:
Address:
City, State, Zip:
Telephone:
Contact Name:
Speaking Fee
(Honorarium):
TERMS & CONDITIONS
(Amount of speaking fee per day and what it includes)
Example 1: $1,000 per day; includes one copy of outline packet (paper or
electronic) with learning objectives. Each outline item must be specific
enough to provide a full description of the content. Following review and
approval of this contract by the National office of the American Association
of Critical-Care Nurses, a down payment of $___ in the form of a chapter
check will be sent to the Speaker. The remaining balance will be paid via a
chapter check, on site upon completion of presentations.
Example 2: $1,000 per day; includes one copy of outline packet (paper or
electronic) with learning objectives. Each outline item must be specific
enough to provide a full description of the content. Following review and
approval of this contract by the National office of the American Association
of Critical-Care Nurses, a down payment of $___ in the form of a chapter
TERMS & CONDITIONS
check will be sent to the Speaker. The remaining balance will be paid via a
chapter check, after the event and upon receipt of the Speaker’s receipts
for approved expenses.
Example 3: $1,000 per day; includes one copy of outline packet (paper or
electronic) with learning objectives. Each outline item must be specific
enough to provide a full description of the content. Following review and
approval of this contract by the National office of the American Association
of Critical-Care Nurses, Chapter will prepare a check for the honorarium to
be paid to Speaker on site, upon completion of presentations.
Speaker is required to complete a W-9 Form to receive his or her
honorarium.
Release /
Disclosure
Agreement:
Speaker will be required to sign a Release/Disclosure Agreement prior to
his or her presentation. (Form located at www.aacn.org/education > CE
Program Approval > AACN Chapter > Resources > Presenter Permissions
& COI Disclosure/Resolution Form. Chapters may use this document, or
use it to develop their own document.)
Expenses Travel:
(Specify the air/ground travel expenses that the chapter will pay, those
dollar limits, and who is responsible for making the travel arrangements.)
Example 1: Mileage to and from (destination) at $0.X cents per mile OR
coach class round trip air ticket to and from (destination) not to exceed $X
dollars.
Example 2: All travel expenses are to be arranged by and billed directly to
the Speaker. The total Speaking Fee (above) is inclusive of all expenses.
Example 3: All travel expenses are to be arranged by and billed directly to
the Speaker. Speaker to provide receipts within two weeks to Chapter
after the event for reimbursement.
(Note: AACN reimbursement for mileage is the U.S. Government’s
mileage reimbursement rate in effect at the time.)
Expenses - Per
Diem:
(Specify the amount per class day/travel days for meals)
Example: Meals per diem for each class day and travel day of $X per day
for a maximum of four days. Speaker required to provide meal receipts for
reimbursement.
Expenses Hotel:
(Specify who is responsible for hotel fees, those dollar limits, and the
dates of sleeping rooms)
Example: Chapter will reserve and pay for two nights (specify date(s)) at X
hotel up to $X per night. If the Speaker chooses at his/her discretion to
seek alternative lodging, upgrade room features or extend lodging
arrangements, those costs will not be reimbursed by Chapter. In the event
TERMS & CONDITIONS
that the Speaker chooses not to accept the two-night reservation, Chapter
will not substitute the value of the room for monetary reimbursement to the
Speaker.
Contact Hour
Application Fee
and Certificates:
If the chapter will be obtaining contact hours through AACN:
Speaker will provide contact hour application information to Chapter in an
electronic format no later than (date) (six weeks preceding the seminar) in
order to gain approval through AACN Program Approval. Contact hour
application completion, submission, certificate printing and payment of all
associated fees will be the responsibility of Chapter. Late submission of
materials, resulting in rush submission fees, will be at the expense of the
Speaker.
-OrPlease select one:
1. Speaker will provide contact hour application and certificates via XXX
(name of provider)
2. Chapter will provide contact hour application and certificates from
provider of their choice.
3. Chapter chooses not to provide contact hours for attendees of the
course.
4. Chapter chooses not to provide contact hours, but will provide CERP
Certificates of Attendance for attendees of the course.
Audiovisual
Equipment:

Speaker will provide (example; laptop computer). If Speaker requires
any other AV equipment they will notify the chapter at least two weeks
in advance.

Chapter will provide (examples; LCD projector, screen, lavaliere
microphone).
Items for
Display:
If Speaker has educational items or products for display, they may display
them only outside of the meeting room for participants to review and
purchase.
Speaker’s
Personal
Belongings:
Lecture
Materials and
Printing:
Speaker will be responsible for his/her personal belongings during the
event.
(Select one)
Speaker will provide Chapter with a copy of the lecture slides and
materials in electronic format no later than (#) weeks preceding the
seminar. Printing costs will be incurred by Chapter with exception of any
materials received beyond the (same # as above) week deadline of (date).
Speaker will provide Chapter with the outline and material for the class.
TERMS & CONDITIONS
Speaker will not provide their slides for copying.
Copyright
Clause:
Example:
The outline packet is intended for Chapter to copy/provide for the sole
purpose of giving to the attendees of the two-day course. It may not be
copied, sold or given away for any other purpose without expressed
written permission of the Speaker.
Additionally, if Chapter will be providing the outline electronically, Chapter
will ensure that only those registered for the class have access and will
limit the length of time the outline is available.
AACN
Recruitment:
Chapter has the right to provide participants with AACN literature in order
to recruit both National and Chapter Members to AACN. Recruitment is
conducted at the Chapter table positioned in the registration area. Chapter
will receive full credit through AACN and associated recognition for all
members recruited.
ADA Clause:
The Speaker agrees to work with AACN in order to meet the needs of any
attendees indicating a requirement for special seating, lighting, and/or
materials due to visual, auditory or other impairments in accordance with
provisions outlined within the Americans With Disabilities Act.
Participants:
It is AACN’s philosophy not to exclude any AACN members from chapter
events. If this presents a problem for any exhibitors/vendors, please
immediately contact the AACN Chapter Department to help reach a
resolution.
Cancellation
Clause:
Examples:
If Chapter cancels the event:
 Cancellation up to 30 days prior to class – no charge for speaker fee.

Cancellation between one to three weeks prior to class – 50% of
speaker fee.

Cancellation in last week prior to class – 75% of speaker fee.

If Chapter cancels the event and does not use the services of Speaker
once the contract has been executed, Chapter may remain fully
responsible to Speaker for the cost of any prepaid expenses such as
transportation tickets, travel change fees, hotel costs or any other
purchases that cannot be refunded.
If Speaker cancels:
 Cancellation up to 30 days prior to class – 25% of any monies paid to
or expenses paid for the speaker will be refunded to Chapter within
five business days.

Cancellation between one to three weeks prior to class – 50% of any
TERMS & CONDITIONS
monies paid to or expenses paid for the speaker will be refunded to
Chapter within five business days.

Cancellation in last week prior to class – 100% of any monies paid to
or expenses paid for the speaker will be refunded to Chapter within
five business days.

If Speaker cancels and the Chapter does not use the Speakers’
services once the contract has been executed, Speaker may remain
fully responsible for the cost of any prepaid expenses, such as
transportation tickets, travel change fees, hotel costs or any other
purchases that cannot be refunded.
ACCEPTANCE
x
Signature
(name), (title), (company name)
x
Phone #
x
Date
x
Signature
(name), President
(chapter name) Chapter-AACN
x
Phone #
x
Date
x
Signature
(name), (title – Treasurer or Chairperson)
(chapter name) Chapter-AACN
x
Phone #
x
Date
Please Note:

All Speaker Agreements with speaking fees of $1,000 or more must be reviewed and approved by AACN’s national
office before signing. Submit online at www.aacn.org/chapters > Forms > Chapter Contract Submission Form.

Please allow up to two weeks for contract review.

All AACN chapter contracts must be signed by the chapter president, and chapter treasurer or appropriate
chairperson.

Please refer to the Chapter Contracts Policy on the website at www.aacn.org/chapters > Contracts.
IMPORTANT INFORMATION:
Information Regarding CEs or CERPs:

If CEs will be applied for/provided to participants, then supporters should pay the chapter and the chapter then
pays the supplier. The chapter should be the middleman and the supporter, the 3 rd party person. Otherwise, only
CERPs would be allowed for the event.

If no CEs will be offered for the event, such as a dinner meeting at a restaurant, then the supporter can pay the
(restaurant) directly. The chapter can then provide a CERP Certificate of Attendance to each participant. The
CERP certificate is free and may be downloaded from the website under Education > CE Program Approval >
IMPORTANT INFORMATION:
Chapters.
Information Regarding Vendor Support of Speakers:

If a vendor supports a speaker for a chapter event it is important for the speaker agreement between the chapter
and speaker to include a statement that the vendor will not influence the speaker’s presentation or content. This
statement should also be included in the Support Agreement signed by the vendor.

If the vendor wants to support the chapter by paying the speaker’s honorarium and travel expenses, the vendor
should pay the chapter, and the chapter then pays the speaker if CEs are to be awarded. If the vendor pays the
speaker, CEs may not be awarded, but a CERP Certificate of Attendance may be provided to participants.

If a vendor supports a speaker for a chapter event, the speaker must make a verbal statement to the event
participants at the start of the presentation to the following effect:
“X vendor is supporting the chapter by paying some of my expenses, and did not
influence the content of my presentation.”
It is the responsibility of the designated nurse planner or chapter representative present at the presentation to ensure
the verbal disclosure is made and the speaker has provided the chapter with the Presenter Permissions & COI
Disclosure/Resolution Form prior to their presentation.