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:___________________________________________    Last 4 of SS#_______________________________________

                                                                                                    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.