Pre-registration Form: UNB Study Tour to Turkey (May 20-June 8, 2004)      <Return>
Print this form for pre-registration, or request a printed brochure from Prof. Murray orProf. Mlls

Name
Address

City                                                                                                                           Prov

Postal Code                                                                                   Email

Tel                                                                                                   Evening

Pre-Registration
To pre-register, I enclose:
__ $300 as a deposit to reserve my place
*Pre-registration payment includes a $50 administration fee and a $150 airfare deposit, which are non-refundable in the event of cancellation by the student prior to full payment.
Comprehensive Insurance [Optional]
__ $202 Blue Cross Total Package/Preferred (under 60)  
__
$278 Blue Cross Total Package/Preferred (under 70)
__ I decline the Insurance Package

*Travellers opting not to purchase the insurance package will be asked to sign a waiver.  All participants must show proof of medical coverage.
Payment
I wish to pay by        ___ Certified cheque         ___ MasterCard          ___ Visa
Name on Card

Card #                                                                                                               Expiry

Signature                                                                                                          Date


Course Selection
__ Credit  __Audit   CLAS 3373 – Myth, Cult and History
__ Credit __ Audit   CLAS 3383 – Art and Architecture

*Pre-registration must be received by January 23rd to gaurantee airfare rates.   To complete UNB registration, the balance of the fees and a UNB registration form must be sent to the Department of Classics & Ancient History, Carleton Hall 239, UNB, Box 4400, Fredericton, NB  E3B 5A3, by February 20th.   Enrolment is limited: we encourage early pre-registration. 
Accommodation
__ Non-smoking   __ Smoking  
__ I wish to room with ............................................................    
__ I wish to have a single room (supplement is $300)

Mail pre-registration form along with deposit and insurance premium [optional] to:
UNB Study Tour to Turkey 2004
The Department of Classics & Ancient History
Carleton Hall 239, University of New Brunswick,
Box 4400, Fredericton, NB  E3B 5A3