Registration

Registration and Payment

"NATURE, HISTORY, SOCIETY, AND CULTURE" - AN EDUCATIONAL AND CULTURAL TOUR OF GERMANY

Registration (below) must be completed for each person enrolling in the tour. Registration deadline: November 15, 2013.

Deposit (USD $300)
Make check to "Intermuse" and send per mail to Intermuse, P.O. Box 28060, Baltimore MD 21239.
Postmarked by November 15, 2013.
OR
PayPal (below) by November 15, 2013.

Remaining Balance (USD $2,097) due by January 30, 2014
Make check to "Intermuse" and send per mail to Intermuse, P.O. Box 28060, Baltimore MD 21239. Postmarked by January 30, 2014.

PayPal for Deposit

(includes $10 service charge for online payment)

310.00

Registration Form

* Indicates required field

Name *

First

Last

Date of Birth *

Email *

Cell Phone Number *

Home Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Passport # *

Passport Date and Place of Issue *

Passport Date of Expiration *

Country of Citizenship *

Name, Relationship, and Phone of Emergency Contact *

I have read and accept all terms and conditions related to "The Best of Germany: Nature, History, Society, and Culture" *

Yes

Agreement *

Comments/Questions *

Submit

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