DESTINATIONS

Group Leader Application Form

Fill out as much information as possible. Fields with asterisks ( * ) are required, although it is highly recommended that you fill out all fields.

Section 1
* First Name:
* Last Name:
* Email Address:	you@domain.com
* Phone Number:	(xxx) xxx-xxxx
Section 2
* Current Address:
* City:
* State:
* Zip:
	You only need to fill out the Permanent Address if it differs from your current address.
Permanent Address:
City:
State:
Zip:
Section 3
* Name of School:
* I am currently a:	College Freshman College Sophomore College Junior College Senior Grad Student High School Senior High School Junior Other
Section 4
* My Spring Break BEGINS On:	(mm/dd/yyyy)
Where did you hear about us?
	If you found us through a search engine, please tell us which one!
* Have you traveled with us before?	Yes No
Tell us about yourself! (activities or organizations you are involved in, where you might want to go for Spring Break, etc.)