EDUCATIONAL FUTURES 191 Main Street
New Canaan, CT 06840
Tel:  (203) 966-6993
Fax:  (203) 966-3832
E-mail: EduFutures@aol.com
  CAMPUS VISIT REGISTRATION FORM

STUDENT'S NAME: _________________________________  E.MAIL ADDRESS: _________________________

PARENT'S NAME(S): ________________________________  E.MAIL ADDRESS: _________________________

DATES AVAILABLE FOR VISIT: (Ideally plan to arrive in New York on a Saturday in order to allow time for
trip briefing and travel to the first destination over the weekend):
  __________________________________

SCHOOLS TO BE VISITED:   _________________________________________________________________

__________________________________________________________________________________________

WHO WILL ACCOMPANY STUDENT (IF ANY):   __________________________________________________

LODGING REQUIREMENTS:   Singles ______   Doubles ______   Smoking or Non-Smoking {circle one}

LODGING PRICE RANGE:   Low ($80 – $110): ____   Medium ($115 – $190): ____   High ($200++)_______
Please advise if any hotel preference or club member (i.e. Marriott, Hyatt, Four Seasons, etc.), or if you
plan to stay with family/friends along the way.


CAR RENTAL REQUIRED:   Yes _____   No _____   Company preference/Club # __________________
Size:   Full-size ________________   Mid-size _________________

WILL YOU REQUIRE A DRIVER:   Yes _____   No _____   Maybe _____

CREDIT CARD NUMBER/EXPIRATION DATE: ____________________________________________________
(Necessary to guarantee hotels, purchase airline tickets, etc.)

SPECIAL REQUIREMENTS AND/OR REQUESTS:

_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________

Please fax this completed questionnaire to 203-966-3832. We will prepare and fax a proposed itinerary for review. Once we receive approval, we will arrange for group information sessions, campus tours and personal interviews, where available, at each school; we will also finalize all lodging and domestic travel details. We would prefer at least four weeks notice to obtain appointments and arrange a worthwhile and efficient trip.