Pioneers of Psychology Tour 2002
Reservation Form

Please read the all-inclusive tour features and conditions enclosed with this form.
Then complete this handy form. Book early!

Make Check Payable to: Southern Adventist University

Mail to:
Pioneers of Psychology Tour
School of Education & Psychology
P.O. Box 370 Collegedale, TN 37315

Accommodation desired:
Dormitory style
Private 2-bed ($20/night/person), sharing with
Private 1-bed ($30/night/person)

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?
___________________________________________________________________________
___________________________________________________________________________

For further questions contact:

School of Education & Psychology		Jon Green
Tel: (423) 238-2765		Tel: (423) 396-3200
Fax: (423) 238-2468		E-mail: jgreen@southern.edu