Edulog Virtual Workshop Registration Your InformationName* First Last Email* Phone*Phone ExtensionJob Title* District Name* State, Province, or Country* Information for up to 5 UsersName of User #1* First Last Email of User #1* Name of User #2 First Last Email of User #2 Name of User #3 First Last Email of User #3 Name of User #4 First Last Email of User #4 Name of User #5 First Last Email of User #5 Payment OptionsEdulog Virtual Workshop Option*Please select the quarter or annual option in which you would like to enroll your team.January, February, MarchApril, May, JuneJuly, August, SeptemberOctober, November, DecemberFull YearPlease select how you will be paying for your conference registration*Please choose Bill Me or Credit Card. Please be aware that you are not being charged right now. We will contact you after you have submitted this form to process your final payment details.Bill MeCredit CardPO numberIf you have a PO number, please enter it here. Credit Card Transaction FeePlease note that there is an additional 4% fee for credit card transactions that will be applied when we contact you to process your final payment details. Price: $0.00 Additional NotesPlease use this field to let us know any additional details about your registration, additional payment information, or other details.TotalPlease note that this estimated total does not include credit card processing fees. We will contact you after you have submitted this form to process your final payment details. $0.00 CAPTCHAEmailThis field is for validation purposes and should be left unchanged.