Delegate Form

Delegate flight request form. Please fill out highlighted Yellow requirements below (All forms should be completed electronically and emailed to [email protected]. Any questions please contact us at 646-880-1537)

PROGRAM INFORMATION

Program Name: Spring 2020: Destination: Africa, South of Sahara

Madagascar: Biodiversity and Natural Resource Management

Arrival Date and Time: Jan 19 2020 Return Date and Time: May 02 2020 (any time) (any time)

Return Departure City: Antananarivo Origin City: New York

Sample Schedule From JFK @ $ 2200

Flights Flt Flight Class of Operated Nr. Airline Departure From Destination Arrival Stops Equipment Time number Travel by (Total) New York, John F. Johannesburg, SA-South Saturday, Kennedy O.R. Tambo Sunday, SA-South W- Airbus 1 African SA 204 01/18/2020 International International 01/19/2020 0 () 14:35 African Economy A340-600 Airways 10:40 AM Airport, Airport, 08:15 AM Airways NY, South Africa United States

Antananarivo, Johannesburg, Antananarivo SA-South Sunday, O.R. Tambo Sunday, SA-South SA G- Ivato Embraer 2 African 01/19/2020 International 01/19/2020 0 () 3:00 African 8252 Economy International 170 Airways 10:00 AM Airport, 02:00 PM Airways Airport, South Africa Madagascar

Delegate Form

Antananarivo, Addis Ababa, Antananarivo Addis Ababa ET- Saturday, Saturday, ET- H- Ivato Bole Boeing 3 Ethiopian ET 852 05/02/2020 05/02/2020 0 () 4:40 Ethiopian Economy International International 737-800 Airlines 02:30 PM 07:10 PM Airlines Airport, Airport, Madagascar Ethiopia Addis Ababa, Addis Ababa Frankfurt, ET- Saturday, Sunday, ET- H- Bole Frankfurt 4 Ethiopian ET 706 05/02/2020 05/03/2020 0 () 350 6:50 Ethiopian Economy International Airport, Airlines 11:40 PM 05:30 AM Airlines Airport, Germany Ethiopia New York, John F. Frankfurt, ET- Sunday, Kennedy Sunday, ET H- Frankfurt Airbus LH- 5 Ethiopian 05/03/2020 International 05/03/2020 0 () 8:40 1610 Economy Airport, A380-800 Lufthansa Airlines 11:00 AM Airport, 01:40 PM Germany NY, United States

Nonrefundable Changeable for a fee 2 bags permitted

Please see below for Personal Details.

PERSONAL DETAILS

Passport First and Middle Names: Passport Last/Family Name:

Nationality: Passport Number

Gender: Date of Birth:

Email Address: Cell Phone Number (Include Country Code):

Additional Information please advise:

Delegate Form