2010 International Marketing European Study Tour Application
Print application, complete ALL information, and
attach photocopy of passport picture page.
If you do not have a passport, obtain one and submit photocopy of passport picture page no
later than February 12, 2010. List your name below EXACTLY as is or will be on your
passport.
| Name (EXACTLY as on passport): |
| Name (as you would like on name tag): |
| Study Tour Roommate’s Name (if known): |
| Passport #: |
Date of Birth: |
Nationality: |
| Emergency Contact
Name: |
|
Contact Phone #: |
|
| Email
Address: |
Student
ID#: |
| (All
Tour correspondence will be sent to this eMail address) |
Gender: [ ] Male
[ ] Female |
|
| Mailing
Address: |
|
| City/State/Zip: |
Phone #: |
|
|
Select one: |
[ ] MKT/INBUS 325 International Marketing ($3,999)
[ ] Non-student ($3,599) |
| |
[ ] MGT 350 Independent Study in International Management ($3,999) |
|
|
|
Submit
your initial $500 deposit payment as follows: |
[
] Check - to "Stevenson University" |
| Credit
Card #: |
[
] VISA [ ] MasterCard [ ] Discover |
| Name
on Card (if different): |
Expiration
Date: |
Additional credit card payments may
be made by calling Student Financial Services at
443-334-3500.
Additional payments by check should be mailed to the
address listed below.
It is your responsibility to submit full payment by February 12, 2010. |
| I have read the course
requirements and payment terms as listed on the 2010 Study Tour Web page
and this application and agree to make full payment by February 12, 2010.
I also understand the cancellation and refund policies. Additionally, I understand that costs
for passports, visas (if
necessary), textbooks, and flight deviations (optional) are my responsibility.
|
Return
this application, deposit, and
passport picture
page photocopy to:
Dr. Lawrence E. Burgee:
Brown School of Business Room 414 (or mail to address at right)
Tel: 443-352-4339, eMail: lburgee@stevenson.edu |
Mail
(if paying by check):
Stevenson University
Attn: Dr. Lawrence E. Burgee
100 Campus Circle
Owings Mills, MD 21117 |
|