Migala Registration Form

The Migala Report Collegiate Sports Management Travel Program Registration Form

Please fill in all fields. You will be notified via email once your payment has been processed. For any questions or if you do not wish to submit your registration online, please call us toll free at (800) 818-1998, Mon-Fri, 8:30AM - 5:00PM PST.

First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:
Evening Phone:
Additional Traveler(s):
Additional Traveler(s):
Room Type:	Single Share Request
Email:
Departure City:
Air Transportation:	Yes No
Pre Beijing Programs:
Post Beijing Programs:
Billing Address
Cardholder First Name:
Last Name:
Address Street 1:
Address Street 2:
City:
State:
Zip Code:	(5 digits)
University:
Credit Card Type:	Visa Mastercard AMEX Discover
Credit Card Number:
Expiration Date:	(MM-YYYY)
Security Code:	3 digit on the back or 4 digit in front for AX
Number of Travelers:
Authorized Amount:
	Nonrefundable deposit of $3000/person due at time of booking.