Return completed application below with the first installment of $900 plus the registration fee.
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| Check One: _____ Three-week Program _____ Four-week Program _____ Six-week Program | |||
| Last Name | First Name | ||
| Address | |||
| City | State | Zip | |
| Phone | Gender | Age | |
| SS# | Passport # | ||
| ACCOMMODATIONS: (check one) | ||
| Barcelona: | Hotel Double Occupancy | |
| Madrid: | Student dorm (Single rooms only) | |
| Paris: | Hotel double occupancy | |
| Lisbon: | Hotel double occupancy | |
| PLACE OF DEPARTURE: (Check one. Surcharge in brackets.) | |||
| New York | Miami ($225) | ||
Getting own airfare (credit $1,025) |
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| COURSES: Select the course number from
those listed in the program. Choose only one course from each section
but do not exceed two. Third course only for six-week program participants M (morning) A (afternoon) |
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| 1. | 2. |
| 3. | |
| Four to Six Week Programs | |
| Package of Four City Tours: $235 | |
| Package of Six Madrid cultural activities : $175 | |
| Barcelona: July 7-10 | Double occupancy $445 | |
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Lisbon: July 7-10 |
Double occupancy $445 | |
| Santiago: July 20-22 | $265 |
Signature ______________________________________________________________________
If under 18 years old, parent or guardian must sign.
| Return completed application and $900 deposit plus the registration fee to:
Dr. Orlando Moreno, Professor Emeritus |