NSHSS Nobel Week 2021: Enrollment Form

NSHSS Nobel Week Tour 2021

Enrollment Form

Tour Dates: December 4-11, 2021
TRAVELER INFO

IMPORTANT: If traveling by air, provide your complete name as it appears on your travel credentials (e.g., birth certificate, passport, or state-issued identification).
LEGAL FIRST NAME*
(No nicknames. i.e. Robert, not Bobby. Important: $100 minimum penalty for name change)
MIDDLE NAME
(Provide only if included on your photo identification. IF your photo identification displays a middle initial, list only a middle initial here. Your name must be an exact match)
SURNAME/LAST NAME*
BIRTHDAY (MM/YYYY)*
Why are we asking? Just to verify that you're eligible for this tour! Only travelers 16 years of age and older are permitted at Nobel Week.
SEX AT BIRTH*

MaleFemale
ARE YOU A U.S. CITIZEN*

YesNo
TRAVELER'S EMAIL*
example@example.com
MAILING ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
PHONE*

Country CodeArea CodePhone Number
SHIRT SIZE*

EMERGENCY CONTACT INFO

IMPORTANT: Contact should not be traveling on tour. This information is required for all tour communication and in case of emergency.
NAME*

PrefixFirst NameSurname/Last Name
RELATION TO PARTICIPANT*

ParentLegal GuardianRelativeSpouseFriend
CONTACT'S EMAIL*
(Email of person not traveling on tour)
PHONE*

Country CodeArea CodePhone Number

TOUR ACCOMMODATION SELECTIONS

Below, you'll see full pricing for this tour based on hostel accommodation type. Make your selections here, and after submitting this form, you will receive an email with instructions to pay your full tour fee at once or in installments. Guests (non-NSHSS Members) are welcome on tour for an additional $250 added to their tour fee. Be sure to complete a separate registration form for any guests!
Select Room Type*

SINGLE ( room to yourself, bed to yourself): $3,750TWIN (room with one other tour participant, bed to yourself): $3,500QUAD (room with three other tour participants, 1 spot in bunk bed): $3,250
I am an*

NSHSS MemberNSHSS Member's Parent or GuestNon-Member (+$250 to separate tour fee)

ROOMMATE REQUEST
Room assignments are made at random unless otherwise specified (please reference the Booking Conditions for room assignment policies). Your roommate request MUST be a paid Nobel Week participant. Travelers who are not on the Nobel Week tour will NOT be roomed with you.:

By submitting this form, I am acknowleding my understanding of the NSHSS Academic Tours COVID-19 Vaccination policy. NSHSS Academic Tours are available to participants who have received their final dose of an approved COVID-19 vaccine at least 14 days prior to the start date and have proof of vaccination.

Proof of vaccination, as follows, will be required at tour check in:
- Original vaccination record issued by the country’s health authority that administered the vaccination (i.e., U.S. CDC's Vaccination Record Card). Copies or photos are not accepted.
- The name and birth date on the vaccination record must match the participant’s travel documents and show the participant is fully vaccinated. The vaccination dates must indicate the participant has completed the required doses no later than 14 days prior to the tour start date. Vaccine type, dates administered, and lot numbers must be clearly visible.
Participants are strongly encouraged to review their vaccination records and ensure they meet our standards, prior to traveling to the starting point of the tour to prevent a situation where they may not be able to participate in the tour.

By submitting this form, I have completely read and fully understand the "Booking Conditions" as supplied herewith, and incorporated herein by reference and agree to be bound by, and to comply with the "Booking Conditions." I verify that I am 16 years of age or older. I understand that I am responsible for paying NSHSS in the amount selected in order to secure my spot and attend the tour.
I agree to the above requirement to be fully vaccinated (2 shots + 14 days) against COVID-19 to attend NSHSS Academic Tours.*

Yes, I agree to comply with the NSHSS Academic Tour COVID-19 Vaccination Policy.

My Products

Nonrefundable Deposit$150.00

Deposit will be used towards total program fee

Total $0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Please verify that you are human*
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TOUR ACCOMMODATION SELECTIONS

ROOMMATE REQUEST