2023 Conference Registration Form
Fill out the form carefully
Name
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
E-mail
example@example.com
Mobile Number
Emergency Contact
Emergency Contact Number
Select your conference package and membership levels. *Please notice the membership level renewal options near the bottom.*
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( X )
Current Member: 3 Day Weekend Package
All workshops on Friday, Saturday, and Sunday
$
125.00
Quantity
1
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10
Current Member: 2 Day Package
Friday and Saturday or Saturday and Sunday
$
105.00
Quantity
1
2
3
4
5
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8
9
10
Current Member: Friday Only
Friday's workshops and events
$
65.00
Quantity
1
2
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10
Current Member: Saturday Only
Saturday's workshops and events
$
75.00
Quantity
1
2
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9
10
Current Member Sunday Only
Sunday's workshops and events
$
55.00
Quantity
1
2
3
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5
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9
10
Non-member: 3 Day Package
All workshops and events, all weekend
$
150.00
Quantity
1
2
3
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5
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9
10
Non-member: 2 Day Package
Friday and Saturday or Saturday and Sunday
$
130.00
Quantity
1
2
3
4
5
6
7
8
9
10
Non-member: Friday Only
All of Friday's workshops and events
$
90.00
Quantity
1
2
3
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5
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9
10
Non-member: Saturday Only
All of Saturday's workshops and events
$
100.00
Quantity
1
2
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10
Non-member: Sunday Only
All of Sunday's workshops and events
$
80.00
Quantity
1
2
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9
10
Under 21: Saturday Only -- Youth Workshops
Four workshops and lunch. 9am-4pm
$
55.00
Quantity
1
2
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9
10
Under 25: Full Time Student (3 Day)
$
65.00
Quantity
1
2
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10
Under 25: Full Time Student (2 Day)
$
55.00
Quantity
1
2
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10
Under 25: Full Time Student (1 Day)
$
35.00
Quantity
1
2
3
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5
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8
9
10
WV Writers Membership: Regular
$
25.00
Quantity
1
2
3
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5
6
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8
9
10
WV Writers Membership: Silver
$
35.00
Quantity
1
2
3
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8
9
10
WV Writers Membership: Gold
$
50.00
Quantity
1
2
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9
10
WV Writers Membership: Full-Time Student
$
10.00
Quantity
1
2
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10
WV Writers Membership: Youth
18 and under
$
5.00
Quantity
1
2
3
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5
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9
10
Don't forget!
I understand that I am responsible for securing my own room and board with Cedar Lakes via their registration form found online at www.wvwriters.org/conferences
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
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