Please read the all-inclusive tour features and conditions enclosed with
this form.
Pint the user printer-friendly format, complete the form and mail it in before
Feburary 15.
Make
Check Payable to:Southern Adventist
University
Mail
to:
Pioneers of Psychology Tour
School of Education & Psychology
P.O. Box 370 Collegedale, TN 37315
Enclosed is my check for $ _______as deposit
($200 per person + $60 for private accommodation) for ___ persons.
Name (Mr., Mrs., Ms.) (as shown on passport)
___________________________________________________________
Address: __________________________________________________________________
City: _________________________________________ State:______
Zip: _______________ Home Phone: ________________ E-mail: _______________
Passport #: ___________ Date/Place of Birth ______________________
Citizenship: ___________________________
Any particular European pioneer, musician, scientist, writer, person, event,
or place
within the scope of the tour in which you might be interested?
____________________________________
_________________________________________________________________
