Classic Travel Direct

	Classic Travel Inc. 4767 Okemos Road, Okemos, Mi 48864 Phone: (517) 349-6200, Toll Free: (800) 643-3449, Fax: (517) 349-6656 e-mail info@classictravelusa.com also see Contact Us

Sample Registration Form

Traveler Name:

Last

First:

Middle Int:

Guest Information:

Last:

First:

Middle Int:

Institution (if applicable) :

Department/Program

I (and/or my guest) have a disability that requires special arrangements Yes No

If Yes, please specify

I (and/or my guest) have food preferences (i.e., vegetarian, restricted diet) No Yes

(if Yes, please explain:

Registration Fees:

Early Registration - before Sept. 01, 2008	Late Registration – Due Oct. 15, 2008
ACDP Member $275	ACDP Member $325
Non-member $325	Non-member $375
Guest $150	Guest $200

Total Registration Fees :

How will you pay for this (select one):
I will be sending you a check in 3 days
Call me to change to my credit card
I will come to the office