Homeschool World ® Event Payment Form

YES! Sign me up for a Homeschool World event listing!

Your Name _______________________________  Title _________________
Event Advertised _________________________________________________
Company Name _____________________________________________________
Address __________________________________________________________
City _________________________  State ______________  Zip ________
Phone ________________  Fax _____________  Email _________________
Your URL (web site address):______________________________________

I want Homeschool World to display my event listing for:

(_) 1 month, $99
(_) 3 months, $199
(_) 6 months, $299
(_) 1 year, $499
(_) 2 years, $799

MC/VISA/AmEx/Discover # ____-____-____-____  Exp. Date _____/_____
I have read and agree to Homeschool World's terms and conditions.
Signature ________________________________________Date _____/_____

Note: Be sure you have first filled in the event submission page with your event's information, clicking the "For Profit" option. We need both an insertion form and your online events submission to process your request.

Questions? Call us at (636) 343-6786 or fax (636) 225-0743.

Return with payment to:
Home Life, Inc., 1731 Smizer Mill Rd., Fenton MO 63026-2635. Fax: (636) 225-0743

Subsequent payments will be billed or charged at current rates as the old payment expires.
Cancel anytime and receive a pro-rated refund, less $50 set-up fee.