Columbus Arts Council’s Travel Application

Name (exactly as it appears on Passport)

First: Middle: Last:

Passport Number: Issued at: Date:

Date of Expiration:

Date of Birth:

Valid Email address:

Cell Phone: Home Phone:

Mailing Address:

Airline Frequent Flyer #:

Emergency Contact Name:

Emergency Contact Phone: Email:

Member of the COLUMBUS ARTS COUNCIL? Yes No

Rooming with:

EXCEPTIONS/ SPECIAL NEEDS (no airfare, single room, etc.):

Your spot is reserved only after the CAC receives your completed application and a $750 deposit.

Please return the completed application to the CAC in person or by mail/email/ fax.

*A 3% surcharge will be added for credit card transactions

COLUMBUS ARTS COUNCIL | Rosenzweig Arts Center, 501 Main Street, P.O. Box 869, Columbus, MS 39703 | | Phone: 662-328-ARTS (2787) | Fax: 662-241-4089

RALPH NULL | | 662-425-1909

For office use only:
DEPOSIT PAYMENT AMOUNT______DATE______
FINAL PAYMENT AMOUNT______DATE______

PLEASE READ! IMPORTANT INFORMATION!

*A 3% surcharge will be added for credit card transactions

Description / Amount / Due Date / Important Notes
Deposit / $750 / Thursday, November 30, 2017 / Refundable up to Tuesday, January 30, 2018 except for a $500 cancellation fee. Refunds may take up to 45 days to process.
Final Payment / $2,145 for
CAC members
$2,245 for
non-members / Tuesday, January 30, 2018 / Once full payment is made, refunds are via travel insurance only.
AIG Travel Insurance / Varies by age / Friday, February 9, 2018
(Paid directly to travel agent) / This is optional yet strongly recommended. See below for more information.

·  The airfare is based upon group air travel which has limited availability for upgrades or changes.

·  We strongly recommend every traveler to buy a traveler’s insurance. Please see attached Travel Guard Group Plan information sheet. If you choose to purchase a plan, please call our Travel Agent, Chuck Tharp, at 570.344.9784 and pay via credit card by Friday, February 9, 2018. He’ll be asking for your billing address, birthday, and email.

·  One checked bag is free with the airline and only one bag will be handled by porters at hotels. Other luggage will be the traveler’s responsibility.