Poland Holocaust Tour | July 1 - July 10, 2022
Please complete a separate registration form for each participant.

A $500 deposit is due upon registration. You will be prompted for payment after submitting this form.

Questions? Please contact Paul Regelbrugge, Director of Education, at Paul@HolocaustCenterSeattle.org. 

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Email *
Last Name *
First Name *
Preferred email address for contact: *
Street Address *
City *
State *
Zip Code *
Phone Number *
This number is my: *
Have you been to Poland before? *
Please tell us a little bit about your interest in this trip: *
How did you hear about this trip? *
Would you like assistance making your plane reservations? *
Are you considering extending your trip?
Do you have any dietary restrictions or allergies? *
Do you have any health, mental health, or mobility issues that might impact your ability to travel with a group? Please explain. *
I would like a: *
I understand that this trip requires a significant amount of walking and am prepared to keep up with a moderate group pace.   Please type your name below to indicate that you understand. *
Are you a teacher who currently teaches in a classroom? *
If you are a teacher, please tell us where you are teaching, grade level, subject, and anything else you would like to include.
Is there anything else you would like us to know?
A $500 deposit is required to reserve your space. You will be prompted to make the payment online after submitting the application. *
I would like to support a teacher traveling to Poland with a gift of: (You will be provided with a separate link to make this gift. Thank you!)
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We look forward to traveling with you!
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