WELS Education Conference

1Personal

2Service/Membership

3Sectionals

4Billing

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Today's date
MM slash DD slash YYYY
Personal Information
Full name(Required)
Prefix First Middle Last Suffix
First name as it will appear on conference badge(Required)
I am presenting a sectional or pre-conference session(Required)
- Yes
- No
Home address(Required)
Address line 1 Address line 2 City State/Province/Region Zip/Postal code Country
Phone 1(Required)
Phone type 1(Required)
Phone 2
Phone type 2
E-mail(Required)
Enter e-mail Confirm e-mail
Dietary restrictions and/or special needs
Emergency Contact
Contact name(Required)
Relationship to attendee(Required)
Day phone(Required)
Evening phone(Required)

Conference fee
Price:
Discount code
Total
$0.00
Verify total(Required)
- Total fee is correct. Proceed to Billing section
- My total is $0
If your total is zero after entering a discount code, please proceed to the privacy policy and then press the Submit button to finish your registration process.
Refund policy: Refunds that are requested in writing before May 31 are subject to a $50 non-refundable charge. No refunds can be made after May 31.
Billing Information
Credit or Debit card information(Required)

Discover
MasterCard
Visa
Supported Credit Cards: Discover, MasterCard, Visa
Card number Expiration date Security code Name on card
Billing address(Required)
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 home address (MUST MATCH WITH BILLING STATEMENT)

Address line 1 Address line 2 City State/Province/Region Zip/Postal code Country
Data Privacy & Permission(Required)
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.