Travel in Canada Participant ListFile # T

Responsible Guider
Name : / iMIS#:
e-mail: / Phone #:
Unit: / Area:
Number of Adults: / Number of Girls:
Date of departure: / Date of return:
Places to be visited:
Flight Numbers (if applicable):
Home Contact
Name: / iMIS#: / Phone #:
e-mail: / Cell #:
PARTICIPANTS
1. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
2. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
3. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
4. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
5. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
6. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
7. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
8. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
9. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
10. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
11. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
12. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
13. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
14. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
15. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
16. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
17. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
18. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
19. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
20. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
21. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
22. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
23. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
24. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
25. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -
26. / Name
iMIS # / Date of Birth / (yyyy) / (mm) / (dd)
To be completed with submission of SG.3
Emergency contact during trip
Relationship to participant
Home Phone / ( ) - / Work Phone / ( ) - / Cell Phone / ( ) -