The16th Annual George H. Muller Veterinary Dermatology Seminar in Hawaii A Postgraduate Symposium Potpourri 2000: Blending the Old and the New! November 1-8, 2000 Kauai Marriott Resort and Beach Club Kauai, Hawaii Presented by the School of Veterinary Medicine, University of California, Davis

Veterinary Dermatology Seminar in Hawaii 2000

Prior to September 15, 2000: tuition is $395, reduced fee of $195 for students.
After September 15, 2000: tuition is $445/$245

Name (Last, First, Mid Init) _____________________________
Degree ______________
SS# (For lifetime learning tax credit)_________________
Practice Name ___________________
Practice Address _________________
City ______________
State_______
Zip ___________
Practice Phone (include area code)
Fax (include area code) __________________
E-Mail Address __________________
Name as you wish to appear on name tag __________________
Name of Spouse/Companion ____________
Golf Tournament (include $85.00 per person) Name(s):_________________________
Name(s):_________________________
Name(s):_________________________
Business Practice Session (include $20/per person):
Name(s) _____________________________

Name(s):_________________________
Name(s):_________________________

2.
___Tuition Fee ($395/$445)
___Business Practice Session ($20)
___Golf Tournament ($85)

Total $______

___Check enclosed (payable to UC Regents)
___Visa#_________________________
___MC#____________________
___AMEX#____________________
Exp. Date_______________________
Name as it appears on credit card _____________________
Signature _______________________________

Tuition check must be in U.S. dollars payable through U.S. bank

Mail to:
Gina Harwood
Office of Public Programs
School of Veterinary Medicine
University of California
One Shields Avenue, Davis, CA 95616-8734

Phone (530) 752-3905
Fax: (530) 752-7563
E-mail: gmharwood@ucdavis.edu
Web URL: www.vetmed.ucdavis.edu/ce/mullerderm.html

Last Name	First Name/Title	Age (if under 18)

Address __________________
City __________________
State __________________
ZIP__________________
Home Phone (include area code) __________________
Office Phone (include area code) __________________
FAX (include area code) __________________
Airline Frequent Flyer Numbers: __________________

Seats:
___ Window
___ Aisle
___ Aisles Across

4.
Air, Hotel and Car Requirements

Please indicate your Air Travel Requirements below:
___ Seven Night Inclusive Package:
(Dates of November 1-8, 2000 ONLY)
___ San Francisco or ___ Los Angeles

OR

___ Please arrange my air travel from: ______________________
Depart Date: ____________ Return Date: ______________
Preferred Airline: ______________________

*Airline Reservations may be requested by calling (toll free) 800-456-3378.

OR

___ I have made my own air travel arrangements.

Please indicate your Hotel Requirements below:
*Some categories have limited availability.
___ Garden View (no lanai)
___ Garden View
___ Pool Ocean View
___ Ocean View
Check-in:_____/Check-out: ______ # of nights ______
Room Requests: ___ Nonsmoking ___ Smoking
___ King ___ 2 Queens ___ Rollaway ___ Crib

Please indicate your Car Rental Requirements below:
___ Compact ___ Midsize ___ Fullsize ___ Minivan ___ Convertible
*Note: if you are using the Inclusive package, a compact car rental is included. Upgrades are available for a nominal fee.

Hotel reservations cannot be confirmed by phone. You must Fax or Mail your signed application to: Passport To Travel, 3501 McHenry Ave. #F18, Modesto CA 95356, FAX: 209 571-5602

5. A deposit of $600.00 will reserve your hotel accommodations. Deposit may be made by check payable to Passport To Travel or by credit card.
*Cancellation fees apply after deposit has been received. See Cancellation Policy.

___ Travel Accommodations $_______
___ Car Rental Upgrade $______
___ Optional Island Activities $_______
Total $_______

___ Check Enclosed (Payable to Passport To Travel)
___ VISA#___________________
___ MC#_________________
___ AMEX#_________________
Exp. Date______________________

All Reservations must be paid in full 90 days prior to your departure. Final payment date: August 1, 2000.

I have read the Cancellation Policy as stated in the brochure and understand that I/WE, and all those for whom this payment applies are subject to those provisions.
Signature ____________________________
Date _________________________

PASSPORT TO TRAVEL
3501 McHenry Ave. #F18
Modesto, CA 95356
TOLL FREE 800 456-3378
Phone (209) 571-5606
Fax (209) 571-5602
TCRC 2008050-10

6.
OPTIONAL ACTIVITIES/TOURS
HAWAIIAN LUAU Friday, Nov. 3
Adults $71.00 #_______
Junior (7-12) $37.00 # _______
Child (2-6) $27.00 #_______

BLACK MOUNTAIN PREMIUM HAWAIIAN COFFEE
Saturday, Nov 4 - $10.00 # _______

CAPTAIN ANDY'S KAUAI SAILING ADVENTURE
Sunday, Nov 5 - $114.00 #_____

EXCLUSIVE WAIMEA CANYON BICYCLE DOWNHILL FROM CANYON TO COAST
Date: __________
Time: _________
Adults $76.00 #_____
Child (10-14) $60.00 #_____

HAWAII MOVIE TOURS
Date: __________
Adults $93.00 #_____
Child (11 &;under) $75.00 #_____

ALOHA CANOES and KAYAK'S CRUISE
Date: ________
Time: _______
Adults $92.00 #_____
Child (5-18) $79.00 #_____

SOUTH SEA HELICOPTER TOURS (min weight requirement 35 pounds)
Date:
___ Nov. 2
___ Nov. 4
___ Nov. 5
___ Nov. 6
___ Nov. 7
Golden Eagle Flight $149.00 #_____
Canyon Bird Flight $188.00 #_____

KAUAI ATV ECO ADVENTURE (Approximately 2.5 hours)
Date:
___ Nov. 2
___ Nov. 3
___ Nov. 4
___ Nov. 5
___ Nov. 6
___ Nov. 7
Time:_____
Adults (must be 16 or older) $88.00 #_____
Optional Rental Clothing $5.00 #_______

ADDITIONAL INTERESTS
___ Kauai Marriott Extension
___ Honolulu/Pearl Harbor
___ San Francisco Extension
___ Los Angeles Extension
___ Other_________________

___ Send me information on the Children's Program

ACCOMMODATIONS & TRAVEL ARRANGEMENTS