WELS Education Conference

1Personal

2Service/Membership

3Sectionals

4Billing

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Today's date

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

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

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

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