National Home Education Conference 2018 Presented by: Canadian Centre for Home EducationRegistration Form
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
English
French
Homeschool Organization (if applicable):
Address:
City:
Province:
Please select...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
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
MM
YY
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