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Photo ID Page

* indicates a required answer.

HERI offers educator and student photo IDs to home educating families.  Below is the pricing:

$ 7 for 1 year (expires in one year)
$10 for 3 years (expires in 3 years)
$12 for 5 years (expires in 5 years)
 
This is a teacher / student ID badge.  It is NOT a HERI membership badge.  
 
THIS FORM IS ONLY TO BE USED IF YOU ARE IN THE PROCESS OF ORDERING A PHOTO ID BADGE IN THE HERI LIBRARY.  AS WE HAVE TO TAKE YOUR PHOTO, THIS SERVICE CAN NOT BE DONE ON-LINE VIA THE INTERNET.  YOU MUST PHYSICALLY BE IN THE HERI LIBRARY.
 
There are no refunds on this purchase. 
1. *

Last Name of individual ordering badge:

2. *

First Name of individual ordering badge:

3. *

Email address of individual ordering badge (for receipt)

4. *

Phone number of individual ordering badge:

5.

Is the badge for a current home educator and/or home educated student?

yes no
6.*

Number of Teacher's IDs being ordered:

7.*

Expiration Date for a Teacher's ID:

8.*

Number of Student ID badges being ordered:

9.*

Expiration Date for a Student's ID:

10.*

I will be paying with:

 (1 required)
Cash Check
Credit or Debit (via PayPal)
11. 

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