AIR TRAVEL REQUEST FORM:
Please return this form 30 days prior to your below scheduled training session in order to guarantee flights & hotel reservations. Your position in the class will not be reserved until this form is received.
NAME (as it appears on your ID):
HOME ADRESS:
CITY: STATE: ZIP:
HOME PHONE: ( )
CELL PHONE: ( )
DEPARTURE DATE/TIME:
RETURN DATE/TIME:
PREFERRED AIRPORT:
DESTINATION:
SEAT PREFERENCE AISLE WINDOW
BE SURE TO CONFIRM ALL MEETING TIMES WITH ADRIA LEWIS
SO WE CAN RESERVE THE BEST FLIGHT TIMES FOR YOU.
CONTACT INFO: ADRIA LEWIS
PHONE: 800.253.8490
EMAIL: alewis@yamaha.com
E-MAIL ADDRESS TO SEND FLIGHT ITINERARY: @
SCHOOL INFORMATION:
SCHOOL NAME:
DISTRICT NAME:
SCHOOL ADDRESS:
CITY: STATE: ZIP:
SCHOOL PHONE ( )
SCHOOL FAX: ( )
COMPUTER TECH NAME:
COMPUTER TECH PHONE: ( )
Yamaha covers the tuition, hotel, and airfare for one teacher per MIE system purchase. If your school wants to train an additional teacher, the cost is $1,800 per person for tuition, hotel, meals and transportation to Washington D.C..
Approx. date of school’s MIE purchase: Month Year
•Are you an additional teacher? Yes No
Please fax this form to 714 522 9833 Please note once ticketed, you will be charged for any changes/cancellations that you request (Min. $450)

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