Eastern Panhandle Home School Conference--Online Registration

Registration Form

Conference attendees may use the form below to register. Fields designated with an asterisk (*) are required.

Vendors, please use the registration form included in the exhibitor package to register by mail.

Registration Form

Name*

First
Last
Suffix

Spouse's/Family Member's Name (if attending)

First
Last
Suffix

Address*

Street Address
Address Line 2
City
State
Zip Code

Phone Number*
-
(###) -
###
####

Email*

Registration Fee:

$25.00--First Family Member $15.00--Spouse/Additional Family Member

Special Lunch Options:

I need a vegetarian option I need a gluten-free option

*Once you click submit you will have the option to pay by Paypal or check. Please see the next window to continue with your payment options.