Christian Educators Conference

1 Attending

2 Billing

Today's date*
Date Format: MM slash DD slash YYYY
Contact Information
A field marked with a red asterisk is required.
Registration type*
- I am registering for myself.
- I am a school principal registering multiple teachers.
- I am a committee member.
Your name*
First Last
Mailing address*
Address line 1 Address line 2 City State Zip code
E-mail*
The link to the conference will be sent to the e-mail given at registration.
Enter e-mail Confirm e-mail
Phone*
I would like a certificate for 4.0 clock hours.*
- Yes
- No
School Information
School name*
City*
State*
Grade/Position*
1. Enter Yes or No if a certificate is requested for 4.0 clock hours.
2. Select (+) to add a new row.
?
Enter ALL who will be attending from your school (see tool tip).*
Note: Faculty members should be aware that personal data is being shared on this form.
First name Last name E-mail Grade/Position Certificate (Yes/No)

Billing Information
Registration fee per person*
Enter number you are registering in Quantity field.
Price: $0.00 Quantity:
Coupon*

Total
Verify total before submitting.
$0.00
Credit or Debit card information*

Discover
MasterCard
Visa
Card number Expiration date Security code Name on card
Billing address*
The address you enter must match the address on file with your bank/credit card company. If the address is not correct or if required fields are left blank, an error message will display.

Same as mailing address (MUST MATCH WITH BILLING STATEMENT)

Address line 1 Address line 2 City State Zip code

Data Privacy & Permission*
I AGREE with the terms of the WELS Privacy Policy.
NOTE TO EU RESIDENTS:

By submitting this form you consent to any and all information you provide and submit via the site being sent to the United States of America. The United States has not sought nor received a finding of “adequacy” from the European Union under Article 45 of the GDPR. WELS relies on derogations for specific situations as set forth in Article 49 of the GDPR. You are also informed that the United States presently does not have an adequate level of personal data protection as determined by the European Commission’s adequacy decision on October 6, 2015 (case c-362/14) and articulated in the European Union’s General Data Protection Regulation and has not received a similar designation of adequacy by any other foreign data protection authority. You agree to the transfer of your data and personal data to the United States, however, to be used in accordance with WELS Privacy Policy.

Peggy Uttech at cese.puttech@gmail.com | Privacy policy
Ref: Christian Educators Conference

First name	Last name	E-mail	Grade/Position	Certificate (Yes/No)