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BEFORE PROCEEDING WITH THE REGISTRATION FORM...
- Yes, I carefully read the Graduate Participation Information page.
  I have carefully reviewed the Graduate Participant Information page and understand how to submit my graduate's information for full participation in the ceremony.
GRADUATE INFORMATION
- Superhero Name
- Graduate's First Name
- Graduate's Last Name
- Parents' Names:
- Phone Number
- Email Address
- Street Address:
- City/Town:
- State:
- Zip:
- Please indicate the approximate number of family/guests planning to attend the ceremony:
- Are you currently a TEACH member?
  If you are unsure your TEACH membership is current, please e-mail an inquiry to gro.tchcaet@pihsrebmem before continuing with registration.
  - Yes
  - No, but I would like to pay an additional $20 today for TEACH membership (1 year).
  - No. I am not interested in TEACH membership at this time.
MEMBERSHIP DETAILS (optional)
Only complete this section if you are paying for TEACH membership today with your event registration.
- Member Type
  - New Member
  - Renewing Member
- Are you a member of HSLDA?
  - Yes
  - No
- Are you a member of a local Support Group?
  - Yes
  - No
- Support Group Name
- Are you currently Homeschooling?
  - Yes
  - No
- May we send your membership card by email?
  - Yes
  - No
REGISTRATION PAYMENT
The event fee per student is $20 for TEACH members and $30 for non-TEACH members.
- Additional Donation (optional)
  Would you help support the ministries of TEACH? Any donation would be appreciated!
- Total
base_price
Amount Paid
Transaction ID
Payment Status
Item Name
Comments, Notes, Feedback
Anything else you would like us to know? Anything you had trouble finding on our website? Did this form give you any trouble?