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GoEngage Order Form

(Est. completion time: 5-10 minutes)
Thank you for choosing GoEngage!
We’re excited to partner with you. Please complete the form below to help us get started on the right track together. If you have any questions, feel free to contact us at [email protected] or (202) 935-0831.
Did you already fill out this information in a PDF or paper copy? Use this link instead

Section 1: Database Setup

Select the type of database you want to be set up for your agency:

Note: We will not import any attachments or documents.
Select the type of database you want to be set up for your agency:
A
B

Specify an Organization ID:

https://storage.tally.so/80cbe15a-ecdb-4bf1-a78d-0c5fafc5d2c2/Screenshot-2024-11-04-141602-1.png
This is the name of your database. Your users will enter your Organization ID to log in to GoEngage.
Only use letters and numbers (no spaces or special characters, please!)

Section 2: Implementation Timeline

When would you like to have your configuration session?

At this time, your Implementation Concierge will sit down with your managers and configure your database with you. See agenda.
We will do our best to accommodate your requested timeframe (and are able to do so 90% of the time), but the final date is subject to your Implementation Concierge's availability. The sooner you submit this Order Form, the better!

When would you like to have your staff trained?

A standard Orientation Training is 18 hours for Head Start, or 12 hours for CAP. You can break it down into 3 days of 6 hours each, or whatever schedule you'd like.
We will do our best to accommodate your requested timeframe (and are able to do so 90% of the time), but the final date is subject to your Trainer's availability. The sooner you submit this Order Form, the better!

When are you planning to start using GoEngage?


Section 3: Support Contacts

Your agency is entitled to unlimited support via phone or email through two (2) designated Support Points of Contact (POCs), who will act on behalf of regular users when engaging the Support Team.
Limiting support requests to two designated Points of Contact (POCs) ensures centralized, consistent communication between your agency and our Support Team. This helps ensure all your users receive the same information about how to use the system, avoiding duplicated or conflicting requests.

Support POC #1

Full Name (Support #1)

Email Address (Support #1)

Phone Number (Support #1)

Job Title (Support #1)

Support POC #2

Full Name (Support #2)

Email Address (Support #2)

Phone Number (Support #2)

Job Title (Support #2)

Additional Support POCs may be added for an annual fee of $150 per person.

If you would like to add additional Support POCs, please provide their name(s), email address(es), phone number(s), and job title(s) here:


Section 4: Billing Contacts

Your Annual Subscription begins on the day your database is ready for use. It will be valid for 12 months and will automatically renew on the same date every year. Invoices are generated annually and sent to your Billing Contacts 45 days prior to the renewal date.

Billing POC #1

Full Name (Billing #1)

Email Address (Billing #1)

Phone Number (Billing #1)

Job Title (Billing #1)

Billing POC #2

Full Name (Billing #2)

Email Address (Billing #2)

Phone Number (Billing #2)

Job Title (Billing #2)

In the event of late payment, your database will be automatically deactivated, resulting in loss of access to the application until full payment is received. A reactivation fee of $225 will apply if the account is deactivated due to late payment.

I understand that a reactivation fee of $225 will apply if my account is deactivated due to late payment.

Signature

Section 5: Next Steps

After we receive the signed agreement, your Implementation Concierge will contact you within 2 business days to introduce themselves, learn more about your agency, and coordinate scheduling for Steps 1-3 of the Implementation Timeline: Get Started

Thank you for completing the Order Form!

We look forward to supporting your agency and helping you make the most of GoEngage. If you have any questions, please don’t hesitate to contact us at [email protected] or (202) 935-0831. Welcome aboard!