Hearts in the Sand Entry Form

Please fill out the Hearts in the Sand Conference entry form below in its entirety. Upon completion and clicking on ‘SUBMIT’ you will be redirected to our PayPal page to process your payment.

Name: *

Address: *

E-mail: *

Phone: *

First Line on Badge - Preferred name for name badge: *
Second Line on Badge - (i.e. pen name, chapter, home town): *

Are you a SWFRW Member? *

Check if interested in consulting with Barbara Vey:

Add On Raffle:
Win a 2-Night Stay at the Embassy Suites by Hilton, Estero/Fort Myers (not applicable during the 2020 Hearts in the Sand dates). Tickets will also be available at the conference.

Single Raffle Tickets:

Multiple Raffle Tickets:

Dietary Restrictions:

PayPal Account E-mail (if different than email entered above):

Cost: Choose one to agree to pay and submit conference fee for the option of your choice below:

Word Verification:

Upon clicking 'Submit & Pay' below, you will be redirected to PayPal to process your payment. You will then return to SWFRW website. Thank you.