EMERALD TRAVEL
AIRLINE/TRAVEL CONSULTANT TRAINING PROGRAM
NON CREDIT COURSE
98-025 Hekaha St. 5A, Aiea, Hawaii 96701 / Phone 808-486-7711
Email:travelclass@emeraldtravelhawaii.net  
APPLICATION FOR STUDENT ENROLLMENT
PERSONAL INFORMATION
NAME: ______________________________________    HOME PHONE: _______________________________

ADDRESS: __________________________________     CEL PHONE: ________________________________

____________________________________________    BIRTHDAY: __________________________________

EMAIL ADDRESS:_____________________________     SSN: _______________________________________

                                                              EDUCATION

        HIGH SCHOOL                                          COLLEGE                                       OTHER

SCHOOL: ____________________   SCHOOL: _____________________  SCHOOL: _____________________

GRADUATED? YES / NO                    GRADUATED?  YES / NO                     GRADUATED? YES / NO

STATE/COUNTRY:  ___________     STATE/COUNTRY:  ___________       STATE/COUNTRY:____________      
  
                                                    
ADDITIONAL SKILLS/INFORMATION

TYPING (wpm) _________________  Foreign Language/s _________________________________________

PLACES TRAVELED: ______________________________________________________________________








Signature: __________________________________   Date: ____________________________________

Print Name: ________________________________     Selected Date for Training: ___________________

                                                                    
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IMPORTANT INFORMATION FOR COURSE APPLICANT:
Your deposit of $200.00 is to reserve your place in the next schedule class
you have selected. Your deposit is non-refundable unless class is  cancelled.
Signature acknowledges important information.