lled in the People to People Delegate Protection Plan (optional insurance).

While this insurance is recommended o travel or 30 days after registration, whichever is later. Details will be provided to enrolled delegates in the first tu

Travel Summary

vel summary. Please review to make sure this is correct. If it is not, please return to travel experiences to select a
United States Leadership Summit 7 Days UCLA - Los Angeles, California Jun 21 2009 - Jun 27 2009 To Be Announced
2

Name:

ons:

e City:

on:

$2,195.00 plus $99.00 for delegate protection plan Grades 5 through 12

Additional fees such as optional upgrades, travel extensions, applicable visas, zone fares, etc. may apply and are not included in base tuition.
2

Departure city and/or dates are subject to change based on availability and capacity.

d Build Version:200811172241

Traveler Information
* Indicates a required field

* Legal First Name: * Legal Last Name: Legal Middle: * Citizenship: * Gender: * Birthdate: * Email Address: * Confirm Email Address:

First name is required Last name is required

Citizenship is required MaleFemale Gender is required

MM/DD/YYYY Enter a date after 1/1/19

Mailing Address

* Country: * Address: * City: * Province: * Postal Code:

Additional Information
* Current Grade
* Find your school Select your grade

Select a school

Your School

Enter your schoo

* Does the traveler have any health problems, behavior disorders, mobility limitations, allergies, sight or hearing conditions which could restrict or substantially interfere with their ability to fully participate in
YesNo

* Please Describe

This field is required.

Safety | Privacy Policy | Terms of Use | Press Room

2008 People to People All Rights Reserved Build Version:200811172241

Parent/Guardian Information

equired field

Name:

ddress:

Email Address:

Contact Phone:

e Contact Phone:

Emergency Contact

me:

me:

ship To Traveler:

Phone

d Build Version:200811172241