2012 Vergilian Society Summer Programs

2012-13 Vergilian Society Summer Programs
Application Form:

Consult www.vergil.clarku.edu for itineraries

Please fill out this form and submit it.

First name: MI: Surname:

Address 1:

Address 2:

City: State/Province: Zip Code:


Phone number:


Academic affiliation: Name of institution

Vergilian Society trips include a great deal of walking, much of it over uneven ground and occasionally in spots offering little shade. Do not sign-up if you have a condition that would make participation difficult or which would be aggravated by walking or heat.

I have a condition which would limit my ability to participate in the program.

I have a medical plan which will cover me while traveling (if needed). yes

Prices for the programs are based on double occupancy. All Vergilian Society accommodations are non-smoking. Hotel rooms are double occupancy usually with bath.

I would prefer a single accommodation (with surcharge) if available. A limited number of singles may be available at the Villa.

Program Fees (not including transatlantic airfare)

Please fill in the name of the program for which you are registering (dates do not include transatlantic travel):