LEARNING AT HOME REGISTRATION FORM
Name _____________________________________________________
Name of your teen(s) who will be attending with you (age 13 and older) #_____
___________________________________________________________________
Address: ___________________________________________________________
___________________________________________________________________
Telephone Number:
__________________________________________________
E-mail Address: _____________________________________________________
Title of Workshop: ___________________________________________________
To reserve my seat for the workshop(s) listed below, enclosed please find a check in the amount of:
*(Please circle all that apply.)
Tuesday Morning Middle School Session: Single $30
Tuesday Morning Middle School Session: Couple $35
Tuesday Afternoon Transcript Session: Single $30
Tuesday Afternoon Transcript Session: Couple $35
Saturday
Morning Alumni Session
Single
$25
Saturday Morning Aumni Session: Couple $30
Cost to attend both Tuesday sessions: $45 single, $55 couple .
Sub Total:
____________
Consultation Services/Fees
1. Need Individualized Help? (4 hour appointment plus resource notebook)
Discounted Fee: $150.00. Payment may be made with registration or at the day of the workshop.
2. Compiling the Home School Transcript: (4 hour appointment plus a Transcript E-book)
Discounted Fee: $175.00.Payment may be made with registration or at the day of the workshop.
Please Note: each of the above packages will begin on Wednesday, using one hour.
The remaining three hours will be used consulting by phone and/or email.
3. Phone Consultation Options:
30 Minutes: $15.00 45 Minutes: $25.00 60 Minutes: $35.00 Discounted Fees
Grand Total: _______________
*Make check payable to Barbara Mesh and mail to:
Dina Fox
14806 Tulip Drive
Tampa, FL 33613