We invite you to join us this summer on an Adventure you'll never forget.  Just fill out the form and click submit to enroll in Alaska Adventure 2008 for Teachers. 

Enrollments are processed on a first come, first served basis.  Limited to space available. Before submitting your enrollment form, be sure to print a copy for yourself.

*Required

*Who Are You? Teacher Principal   *First Name

*Last Name  Preferred name

*Home Address

*City   *State

*Zip   *Phone

Cell   *Email address

*School *School State

*Position   *Grade/Subject

School Year Ends

*Where have you traveled?

*Emergency Contact/Phone 

*Allergies, special food needs

Participating with a Colleague/Friend? Yes No

If yes, name of Colleague/Friend

Yes, I'd like to take part!

Enclosed is my check in the amount of $400 as a deposit toward participating in the Alaska Adventure for Teachers.  Checks should be made payable to Earth Explore, and should be mailed along with a printed and signed copy of this form to Earth Explore Adventures, 4831 Lucy Court, Santa Rosa, CA 95405-7461.

Payment may be made by credit card.  To pay by credit card, simply fill out the form leaving the credit card information blank.  Print the form, complete credit card information, sign and fax or mail to Earth Explore Adventures, 4831 Lucy Court, Santa Rosa, CA 95405-7461.  FAX 707.538.7438.

Please indicate MasterCard Visa Discover

I authorize $400 deposit to be charged to my credit card.   Bill me for the balance. Tuition to be paid in full by May 15, 2008.

Card Number

Expiration Date

Signature Date

I have read, understand, and agree to the program Enrollment Agreement contained in the Trip Fact Sheet.