Intervarsity SC20: January 2020 Please enter your name as it appears on the government issued ID you will you use at the airport. Question Title * 1. First Name: Question Title * 2. Middle Name: Question Title * 3. Last Name: If you are an employee with Intervarsity, please provide your Intervarsity email address as this is how we validate you are approved to have your trip paid for. If you are not an employee, provide any email address you would like us to use for your trip. Question Title * 4. Email Address: Question Title * 5. Phone Number: Question Title * 6. Address Address Address 2 City/Town State/Province -- select state -- AL AlabamaAK AlaskaAS American SamoaAZ ArizonaAR ArkansasCA CaliforniaCO ColoradoCT ConnecticutDE DelawareDC District of ColumbiaFM Federated States of MicronesiaFL FloridaGA GeorgiaGU GuamHI HawaiiID IdahoIL IllinoisIN IndianaIA IowaKS KansasKY KentuckyLA LouisianaME MaineMH Marshall IslandsMD MarylandMA MassachusettsMI MichiganMN MinnesotaMS MississippiMO MissouriMT MontanaNE NebraskaNV NevadaNH New HampshireNJ New JerseyNM New MexicoNY New YorkNC North CarolinaND North DakotaMP Northern Mariana IslandsOH OhioOK OklahomaOR OregonPW PalauPA PennsylvaniaPR Puerto RicoRI Rhode IslandSC South CarolinaSD South DakotaTN TennesseeTX TexasUT UtahVT VermontVI Virgin IslandsVA VirginiaWA WashingtonWV West VirginiaWI WisconsinWY Wyoming ZIP/Postal Code Country Question Title * 7. Date of Birth: Date / Time Date Question Title * 8. Gender: Male Female Question Title * 9. Known Traveler Number if you have one: Question Title * 10. Are you approved to have Intervarsity pay for your trip? Yes - I am an employee. Yes - I am a spouse of an employee and am attending the conference. No I don't know Question Title * 11. How will you pay for your trip? I do not have an Intervarsity credit card. Please charge the global Intervarsity credit card. I will provide my own credit card. (use the link on the Conference's travel page to download and fill out the credit card authorization form) Question Title * 12. Seating Preference Aisle Window Question Title * 13. Airline Frequent Flier Programs Delta American United Question Title * 14. Other frequent flier programs on different airlines or car rental companies we may need for your reservation ? Please put in the airline and number: Question Title * 15. What airport are your starting your trip from? Question Title * 16. What date do you want to fly to the conference? Please refer to the conference event dates on the conference website. Date Date Question Title * 17. Do you have a time you hope to arrive by? For example, you could write "arrive by 9am." Leave this blank if you're flexible for best pricing options. Question Title * 18. What date do you want to depart from the conference? Please refer to the conference event dates on the conference website. Date Date Question Title * 19. Do you have a specific time range for your flight departure time? If so, please provide what works for you. For example, you might write "no flights departing before 5pm." Leave this blank if you're flexible for best pricing options. Question Title * 20. What airport do you want to return to after the conference? Question Title * 21. Do you have a time you want to arrive by? If so, please share a time or time range. Question Title * 22. Anything else you want us to know about your trip? Thank you for filling out the survey! After you click "Done" your form will be received by Burkhalter Travel, and we will be in touch to schedule your travel. Done