Teacher Photo ID

Teacher/Home Educator Photo ID Card

Note: this form accepts credit card payments only.

Teacher Photo ID Information

Name as it will appear on card:

Name of your Homeschool:**

**For example, Smith Homeschool Academy. No more than 30 characters including spaces.

Language on Card

EnglishFrench

Homeschool Organization (if applicable):

Address:

City:

Province:

Postal Code:

Phone:

E-mail:

*By providing your e-mail addresses, please note that this will become the primary means of contacting you in regards to your order.

Photo Upload

Photo of the Teacher/Home Educator

Jpeg format
Photos must be clear, sharp and in focus
Photos should show a full front view of the face and top of shoulders
Hats or sunglasses are not recommended
No smaller than 2"x2"
Portrait Orientation
High/Original resolution

Payment Information

HSLDA Members- $15 each per card per school year. # of cards:

HLSDA Member Number

Total $

Non-HSLDA Members*- $20 each per card per school year. # of cards:

*Non-HSLDA members must provide proof of homeschooling such as a copy of your provincial or territorial registration/notification or a letter from your homeschool support group president/chairperson.

Total $

Grand Total $

Name on Card

Card Number

Code

Card Holder E-mail

Note: merchant name on credit card statement will be Canadian Centre for Home Education (CCHE)

*By submitting this form, I certify that the information provided above is accurate and complete to the best of my ability.

Contact Information