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