Registration

Name: *


Spouse Name:


Support Group Name: *


Leadership Position:


Home Address:


City, State, Zip:


Phone:


Email: *


Subject: *
2010 Leadership Conference Registration

As a home school leader, what is the biggest challenge that your or your group is facing at this time?


What topics would you like to suggest for discussion during our Town Hall Session?


Lunch Details: Your registration fee includes a boxed lunch of your choice catered in by Jason's Deli *
Turkey on Whole Grain - Traditional sandwiches include potato chips, pickle, and a cookie.
Turkey on White
Ham on Whole Grain
Ham on White

Spouse Lunch: *
N/A
Turkey on Whole Grain
Turkey on White
Ham on Whole Grain
Ham on White

Please check your registration preference: *
$25/person (Postmarked on or before July 30)
$35/couple (Postmarked on or before July 30)
$35/person (Postmarked after July 30 or at the door)
$45/couple (Postmarked after July 30 or at the door)

Are you a HEART of Texas member or Board member of a partnering home school organization? *
No Yes ($10 discount)