Acceptance and Travel Confirmation Form
The scholarship to the 2018 Foundation Futures Program that has been offered to you. If you did not receive a full award, you will be responsible for all travel and lodging expenses incurred to attend the Futures Program.
Check here if you accept the
2018 Foundation Futures Program.
Special Dietary Needs
Please indicate what is your special dietary need.
I will share a room with another Foundation Futures participant at the Gaylord Texan.
Check here to authorize AMDA to charge your credit card for half the cost of a double room per night (room cost is $222 plus tax per night).
Roommate Requested (Optional)
Roommate requests can only be granted if both Futures participants request each other.
I prefer to have my own room.
Check here to authorize for 4 nights credit card charge listed below at the Gaylord Texan
I will make my own hotel arrangements at another property.
Check here to acknowledge that you will be responsible for all costs associated with your stay.
Name on Card
Type your full name and date to authorize The Gaylord Texan permission to charge your credit card for the amount indicated on or after the indicated date. This is permission for a single transaction only, and does not provide authorization for any additional unrelated charges to your account.
I understand that cancellation after acceptance into this program will be subject to review by the Foundation Futures Committee. Participant may be responsible for any expenses incurred on behalf of the participant, including but not limited to transportation and housing, and may not be eligible to receive AMDA membership benefits.
Check here to acknowledge cancellation policy
ACCEPTANCE MUST RECEIVED BY:
Friday, January 12, 2018
Do Not Fill This Out