sls application form 2015
DESCRIPTION
Sustainability Learning Series: Aboriginal TourismTRANSCRIPT
Application Form
Sustainability Learning Series 2015
Please print all information; submit this form by email to [email protected] in person to: Nicole Vaugeois, Building 250 Vancouver Island University, 900 Fifth Street, Nanaimo, BC V9R 5S5LEARNING SERIES
( Aboriginal Tourism - June 8-13th, 2015
PERSONAL INFORMATION
NAME
ADDRESS
CITYPROVINCEPOSTAL CODE
CountryStatePostal Code
DATE OF BIRTH:
_______/________/_______
DAY MONTH YEAREMAIL:HOME PHONE: ( ) -
CELL PHONE: ( ) -
MEDICAL NUMBER AND PROVINCE OF ISSUE
VIU STUDENT # (if appropriate)
YEARMAJOR
ORGANIZATION (if appropriate)
MAY WE RELEASE YOUR NAME AND CONTACT INFORMATION TO OTHER PARTICIPANTS ( YES ( NO Unless there is a promotional reason for this delete it and implement at the beginning of the tripEMERGENCY CONTACT
NAME
PHONE NUMBER
( ) -RELATIONSHIP
TRAVEL PLANNING INFORMATION
LIST ANY ALLERGIES WE SHOULD BE AWARE OF
LIST ANY SPECIAL DIETARY REQUIREMENTS FOR ANY MEALS OR SNACKS THAT MAY BE PROVIDED
LIST ANY PHYSICAL LIMITATIONS OR DISABILITIES WE SHOULD BE AWARE OF
STUDENTS: IF APPLICABLE: NAME OF APPLICANT YOU WOULD LIKE TO SHARE A ROOM WITH?
CANCELLATION POLICY Does a two week cancelation policy allow enough time based upon committed reservation policies or does the statement need to read four weeks? A minimum of 10 participants is required to implement and deliver the Learning Series. If the numbers do not warrant program delivery, three weeks prior to the start date all registered participants will be refunded 100%. The Aboriginal Tourism Planning Committee reserves the right to make the final decision. REFUND POLICY
Deposit is non-refundable if a participants cancels three weeks prior to program start.I AGREE TO THE ABOVE CANCELLATION AND REFUND POLICY.THE INFORMATION ON THIS FORM IS COLLECTED UNDER THE AUTHORITY OF THE COLLEGE AND INSTITUE ACT. THE USE OF THIS INFORMATION WILL BE IN COMPLIANCE WITH THE FREEDOM OF INFORMATION AND PROTECTION OF PRIVACY ACT. ANY QUESTIONS CONCERNING THE COLLECTION AND USE OF THIS INFORMATION SHOULD BE DIRECTED TO Nicole Vaugeois [email protected].
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SIGNATURE
DATE