Click ABOVE
...to download a copy (PDF) of the INFORMATION FORM 
NOTE: This form may be filled out AFTER the NWACC Foundation Reservation Form has been submitted

Summer 2018 - General Traveler Information

Please fill out a Information form for each person registering for TEN DAYS in TUSCANY. This is should be filled out in addition to the NWACC Foundation Sign-Up form. Thanks.

Print Your First Name: ______________________________________________________ 

Print Your Last Name: ______________________________________________________ 

Mailing Address:_____________________________________________________________________________

PRINT E-mail__________________________________________________________ 

Re-PRINT E-mail_______________________________________________________

Work Phone: ______-______-_____________ 

Cell Phone:_______-______-_____________

Additional Travel Cell Phone (if you carrying one) ______-______-_____________

Date of Birth - Month: ______________ Year: ______

Do you have a passport? YES ______ NO ______ 
Your Name as it appears on your passport: ____________________________________________________________________

(IMPORTANT: Please be sure and check that your passport is current AT LEAST 6 MONTHS after the end date of this trip. If it expires sooner, you must get it renewed.)

Passport Expiration Date: ________________________________________________

Your Doctor’s Name and Phone Number (optional):__________________________________________________

Emergency Contact’s Name & Phone Number (family/friend at home)

​____________________________________________________________________________________________

Do you have any allergies or dietary issues that might cause you problems on an international trip? ___________
If Yes please describe/explain. ____________________________________________________________________________________________

____________________________________________________________________________________________

Do you have any health issues that limit mobility? _______ 
If yes, please describe. ____________________________________________________________________________________________

____________________________________________________________________________________________

(Please note that the tour sometimes involve walking that could last up to 2 hours. Also, some of the Tuscan hill-towns have cobbled streets and some are steep. To insure your touring experience is enjoyable, it is important the you and I discuss any mobility issues that may concern you. All walking tours are optional.)

Single room accommodations are available at additional cost. Triple room as sometimes available.

Print name of spouse/roommate:

_____________________________________________________________________ 


COST
Ten Days in Tuscany 2018: $2,690.00 per person, double occupancy, Standard room; $2,896 Superior room.
Cost includes meals, lodging, excursions stated on the “Ten Days in Tuscany” web page located at www.MilesFish.com

From this cost, a $200.00 donation ($400 per couple) will be made in your name to the NWACC FOUNDATION to support NWACC in ITALY study abroad scholarships.

Note that the TEN DAYS in TUSCANY cost does not include transportation to Siena or Siena's daily city tax of €2.50 ($3.00) per person that will be due upon checkout of the Palazzo Ravizza Hotel. 

  • REFUNDS: 100% refund if canceled BEFORE the date set by NWACC Foundation Office
  • No refunds or cancelations are possible after that date
  • Payments are due in full by the final due date

ADDIDTIONAL INFO:
Is there anything else we need to know before we go? ____________________________________________________________________________________________

____________________________________________________________________________________________ 

​
Is there anything we can do to help you get ready or plan for this trip?____________________________________________________________________________________________

____________________________________________________________________________________________ 

PLEASE INFORM ME AND THE NWACC FOUNDATION OFFICE OF ANY CHANGE IN YOUR MEDICAL CONDITION SINCE YOU FILLED OUT THIS FORM. This includes all hospitalization and treatment since sign up date that may affect your ability to do our tour safely and comfortably. Thanks 

NOTE. The following will be posted on the “Ten Days in Tuscany” page at www.MilesFish.com and on the “Ten Days in Tuscany” Facebook page
  • Trip Updates 
  • Detailed day to day itinerary 
  • Hotel address/phone number 
  • Helpful travel info 
  • My personal travel phone number

ALSO NOTE: A month prior to departure I will send daily emails with information I think might be helpful to getting the most out of living in Tuscany for Ten Days.

Please read below and sign. Thanks, MILES:

“I have read the information above and I acknowledge that...
  • My reservation will not be official until after the first deposit is received. I realize that after December 31, 2017 no refunds can be provided and full payment will be required by the final due date of March 1.
  • The cost does not include air transportation to Italy and does not include Siena's daily city tax of €2.50 ($3.00) per person that will be due upon checkout of the Palazzo Ravizza Hotel.
  • The cost of the trip includes a $200 donation in my name to support NWACC's Study Abroad Student Scholarship funds.”

Please acknowledge by marking the ‘YES’ box and sign below.

YES: _________ 

Signature: ________________________________________________________ 

Date: ____________________________________________________________ 

(Note couples should each fill out this form and submit separately. Thanks.) 

QUESTIONS: email Miles at milesfish@mac.com 


________Check here if you are interested in the Venice with the group.