Consult www.vergil.clarku.edu for itineraries
Academic affiliation: Name of institution____________________________________________
Your relationship: ____teacher ____ student ____ administrator ____ alumnus/a
Vergilian Society trips include a great deal of walking, much of it over uneven ground and occasionally in spots offering little shade. Do not sign-up if you have a condition that would make participation difficult or which would be aggravated by walking or heat.
( ) I have no condition which would limit my ability to participate in the program.
( ) I have a medical plan which will cover me while traveling (if needed).
Prices for the programs are based on double occupancy. All Vergilian Society accommodations are non-smoking. Hotel rooms are double occupancy usually with bath.
( ) If possible, I would prefer to room with_________________________
( ) I would prefer a single accommodation (with surcharge) if available. A limited number of singles may be available at the Villa
Program Fees (not including transatlantic airfare)
--All prices are per person for double accommodations;
--All programs are contingent upon enrollment; Do not make flight arrangements until you are alerted that we have sufficient participants!
--All prices include a $200 tax-deductible contribution to the Vergilian Society.
--Breakfast is included in all tours. Lunch and dinner are included in days spent at the Villa Vergiliana. Some meals may be included on tours that are not staying at the Villa. Please consult the individual itinerary.
Please check the program for which you are registering (dates do not include transatlantic travel):
[ ] ROMAN PROVENCE
Dec 27,2013-Jan 4, 2014 or Dec 24, 2013-Jan 4, 2014
Director, Beverly Berg
Price:Price: Long Version: $1895, single supplement of $300.
Short Version, $1595, single supplement of $250.
( ) I have enclosed $750 (Non-refundable deposit of $550 and a required tax deductible contribution of $200.)
( ) I will pay via the Internet, using a credit card.
( ) I understand that, unless the program is cancelled, my deposit is non-refundable.
( ) I am enclosing the entire amount at this time.
By signing this application form I agree that neither the Vergilian Society, Inc., nor its agents will be responsible for any loss, injury, or damage to me or to my belongings or otherwise in connection with any accommodation, transportation or other services or resulting directly or indirectly from any occurrences beyond their control including breakdown in equipment, labor strikes, or natural disasters. I declare that I am aware of the program description, and understand that slight modifications in the itinerary may occur. I understand that all my money will be refunded if there is insufficient enrollment.
( ) I understand that this trip may include some walking over uneven terrain. I acknowledge that it is my responsibility to alert the tour directors when I feel that it would be better that I not participate in a particular segment of an outing.
( ) I understand that the first and last day of all the Italy-based trips are tour days, and that departure and arrival flights cannot be planned for those days.
Name(signed) _______________________________date _____________
Make checks (payable in U.S. funds) to The Vergilian Society. Send application form and payment to:
V.S. Study Tours,
101 N. University Ave.
Beaver Dam, WI 53916
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