Honorarium Agreement, Financial Policy and W-9 - American Osteopathic College of Dermatology

Finalize your honorarium details, tax documentation, and travel policy acknowledgment. Banking details you enter here are stored encrypted and visible only to authorized AOCD accounting staff.

Welcome to the AOCD Speaker Resource Center. Please complete this form to finalize your honorarium details, tax documentation, and travel policy acknowledgment. You may click Save and Continue Later at any time to return and complete your submission prior to the deadline.

Company

This field is for validation purposes and should be left unchanged.

Section A: Speaker Identification

Full Legal Name(Required)

First name, middle initial, last name.

Primary Email Address(Required)

Main contact email. Used to send you a copy of this agreement and your Save and Continue link.

Payee / Legal Entity Name(Required)

Full legal name or LLC name as it should appear on honorarium payments and tax forms.

Section B: Honorarium & Payment Options

Honorariums are paid in accordance with official AOCD board policy ($2,000/hr live or live-streamed, prorated for session duration; $500 flat stipend per mutually approved archived lecture). Total honorarium amounts are finalized based on your confirmed presentation schedule.

Honorarium Preference(Required)

Accept Honorarium

Decline Honorarium

Donate Honorarium to AOCD Foundation

Select payment handling.

Payment Method(Required)

Direct Deposit / ACH

Paper Check via Mail

How would you like to receive payment?

Bank Routing Number(Required)

Nine-digit ABA routing number. Stored encrypted and visible only to authorized AOCD accounting staff.

Bank Account Number(Required)

Stored encrypted and visible only to authorized AOCD accounting staff.

Account Type(Required)

Checking

Savings

Mailing Address for Check(Required)

Street Address Address Line 2 City State ZIP Code

Street address, city, state, ZIP code.

Section C: Tax Documentation (W-9)

Signed Form W-9 Upload(Required)

Accepted file types: pdf, jpg, jpeg, png, Max. file size: 15 MB.

Upload a current, signed Form W-9. Accepted formats: .pdf, .jpg, .png. Max file size: 15 MB.

Download a blank fillable IRS Form W-9 (PDF)

Section D: Honorarium, Travel & Lodging Policy Acknowledgment

Please review and check off agreement to each policy item below before signing.

1. Honorarium Rates & On-Demand Pre-Approval(Required)

Standard honorariums are structured at $2,000 per lecture hour (prorated for shorter durations, e.g., 30 min = $1,000). This rate applies equally to live and live-stream presentations. For panel discussions and co-presented/shared presentations, each speaker receives the full prorated hourly honorarium (honorariums are not split or fractionalized). Archived On-Demand Content: Recording and archiving a lecture for subsequent on-demand access is not automatic and requires explicit mutual pre-approval by both AOCD and the speaker. AOCD must formally request to archive and utilize the recording, and the speaker must provide written/digital agreement. Upon mutual approval and deployment of the archived lecture, an additional flat $500 stipend per recorded presentation will be paid to the speaker regardless of presentation length.

I Agree

2. Self-Booking & Advance Purchase(Required)

Travel Booking: Speakers are free to book their travel independently. However, every effort must be made to book travel as early as possible to avoid inflated, last-minute fare prices.

I Agree

3. Airfare, Cabin Class & Fare Comparison(Required)

Air Travel & Upgrades: AOCD reimburses roundtrip coach/economy airfare from the speaker’s home of record to the conference city. Checked bags are reimbursable, but seat upgrades are non-reimbursable. If a speaker chooses a cabin class higher than roundtrip coach/economy, they must submit a screenshot of the coach/economy fare for the exact same flight at the time of booking to establish the reimbursement cap.

I Agree

4. Personal Itineraries & Indirect Routing(Required)

Travel Routing Caps: If travel includes personal itineraries, extended stays, or indirect routing, reimbursement is strictly capped at the cost of direct roundtrip coach airfare between the speaker’s home city and the conference city for the official event dates.

I Agree

5. Ground Transportation & Rental Cars(Required)

Ground Travel Policy: Standard local transportation via taxi or standard rideshare service (Uber, Lyft) between home/airport/hotel is reimbursable (gratuities covered up to 20%). Premium black car / limousine services and rental cars are strictly non-reimbursable.

I Agree

6. POV / Mileage Reimbursement(Required)

Personal Vehicle (POV) Travel: AOCD reimburses personal transportation via vehicle at the standard IRS mileage rate for the current calendar year. Total reimbursement shall not exceed the equivalent cost of roundtrip coach airfare from the home of record to the conference site.

I Agree

7. Approved Incidentals (Parking & Tolls)(Required)

Covered Travel Incidentals: AOCD covers airport parking, hotel parking, and highway tolls incurred during travel to and from the conference.

I Agree

8. Non-Reimbursable Expenses (Meals & Food)(Required)

Excluded Expenses: AOCD does not reimburse meals, food, snacks, or beverage expenses incurred during transit or while on-site at the conference. (Meals and light refreshments are provided during official conference programming.)

I Agree

9. Official Conference Hotel Requirement(Required)

Approved Lodging: Speakers must stay at the official host conference hotel. Alternate accommodations (e.g., non-contracted hotels, Airbnb, VRBO) are strictly non-reimbursable.

I Agree

10. Hotel Nights Covered(Required)

Approved Lodging Duration: AOCD pays for one (1) night at the conference hotel. If a speaker is scheduled to deliver lectures across two different days, AOCD will cover multiple nights corresponding to the presentation schedule.

I Agree

11. Hotel Reservations & Incidentals(Required)

Master Account & Incidentals: Room rates, mandatory taxes, and resort fees for approved nights are covered by AOCD. Speakers are required to book their hotel room and guarantee the stay with a personal credit card upon check-in. All personal hotel incidentals (room service, mini-bar, spa, laundry) are the sole responsibility of the speaker.

I Agree

12. Cancellations & Guest Travel(Required)

Cancellations & Spousal/Guest Costs: In the event of a voluntary speaker cancellation, AOCD is not responsible for non-refundable travel expenses incurred by the speaker. If AOCD cancels or postpones a session, AOCD will reimburse non-refundable travel expenses booked prior to written notice. All travel, lodging, or incidental costs incurred for accompanying spouses, family, or guests are strictly non-reimbursable.

I Agree

13. Receipt Submission & Payment Timeline(Required)

Submissions & Payment Processing: Itemized receipts are required for all reimbursable expenses (airfare, baggage, ground transit, parking, tolls, etc.). Reimbursement requests and receipts should be submitted within 30 days post-conference. Honorarium and expense reimbursement payments will be made within 30 days of receiving the completed AOCD Expense Reimbursement Form, regardless of when submitted.

I Agree

Section E: Attestation & Electronic Signature

Electronic Signature(Required)

Type your full legal name to serve as a binding digital signature on this agreement.

Date of Signature(Required)

Date of signature.