tripreg

Alliance Française of Birmingham
Springtime in Paris 2010 Registration Form
VERY IMPORTANT - PLEASE PRINT YOUR NAME EXACTLY AS IT APPEARS IN YOUR PASSPORT. THANK YOU.
(Please complete a separate form for each person traveling)

Last:___________________________________ First:_____________________________

Address:________________________________________________________________

City:________________________ State:_____________________ Zip:_____________

Phone: Home_______________ Work______________ Email:____________________

Please circle: UAB employee? YES / NO

Alliance Française Member? YES / NO
(Online membership form available at: www.afbirmingham.org)

SINGLE / TWIN / DOUBLE - YOUR ROOMATE:___________________________
(1 bed) (2 beds) (1 bed)
I DO NOT HAVE A ROOMATE BUT WOULD LIKE TO SHARE A ROOM:________

Days / Nights

Dates-March 2010

Total Cost
(Double occupancy)

Single supplement

Deposit
(no refund after 11/16/09)

Due by 11/16/09

First Payment

Due by
12/14/09

Final Payment

Due before 01/31/10

8/7

3/13 - 3/21
UAB & BSC Spring Break

$1,799.00

$500.00

$199.00

$800.00

Balance

4 OPTIONAL DAY TRIPS (Don't send money for trips now, just circle the trips you want).
NORMANDY: $150. Bayeux Museum and Omaha Beach American Cemetery YES / NO		CASTLES OF THE LOIRE VALLEY: $150. YES / NO
REIMS CATHEDRAL & CHAMPAGNE WINERY: $150. YES / NO		CHARTRES CATHEDRAL & VERSAILLES: $150. YES / NO
PARIS BY NIGHT CITY TOUR $30.	YES / NO

Please Mail This Form with Deposit of $199.00 (per person, non-refundable) by November 16, 2009.
(Please add $50.00 if you are not a UAB employee or an Alliance Française member)
Make Check Payable To: Alliance Française of Birmingham
Mail to: 413 Clermont Drive, Birmingham, AL 35209