MADRID APPLICATION
Last Name First Name
Address
City StateZip
Phone DOBAge
Sex Passport No.
ACCOMMODATIONS: (check one)
Madrid:   Student dorm (Single rooms only)
Barcelona: Hotel double occupancy
 Optional: Single accomodations $80
PLACE OF DEPARTURE: (Check one. Surcharge in brackets.)
 New York Miami ($80)  Tampa ($145)
 Orlando ($145) Atlanta ($185)  Other City __________________
COURSES: Select the course number from the ones listed in the Program. Choose only one course from each section but do not exceed two.
1.2.
CULTURAL PROGRAM: (Check your choices)
 Package of Six Tours: $125
 Package of Exploring Madrid Morning Visits: $50
Andalucia Excursion:
4 days
  Double accom. $295
 Single accom. $360
Santiago Excursion:
4 days
  Double accom. $275
 Single accom. $330
Paris Excursion:
4 days
  Double accom. $425
 Single accom. $485
Return completed application with the first installment of $650 to:

Dr. Orlando Moreno, Dean, Communications/Fine Arts Division
Central Florida Community College
P.O. Box 1388
Ocala, FL 34478-1388

Signature ______________________________________________________________________
If under 18 years old, parent or guardian must sign.

Group Reference: ________________________________________________________________

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