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DHS Music to IRELAND 2022
Detail for each traveler for April 2-9, 2022
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* Indicates required question
B) Traveler LAST NAME as printed on school ID/CDL/Passport
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Your answer
C) Traveler FIRST NAME as printed on school ID/CDL/Passport
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Your answer
D) Traveler MIDDLE NAME as printed on school ID/CDL/Passport
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Your answer
Traveler EMAIL ADDRESS that is checked at least once a day. (Students DO need a address that goes to them specifically.)
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Your answer
Traveler CELL PHONE ###-###-####
*
Your answer
E) Traveler DATE OF BIRTH MM/DD/YYYY
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Your answer
F) Traveler GENDER (M/F) as noted on Passport
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Male
Female
N) Valid Passport Number (valid means it does not expire before Sept 2022) OR "I need to renew/get one." ALSO, if you have a VALID passport, while you are recording this detail, SCAN OR SNAP A PICTURE of the page with your PHOTO, PASSPORT NUMBER and EXPIRATION DATE and send to Liz Crocker.
LFCrocker@yahoo.com
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Your answer
O) Passport Expiration Date (Month/Day/Year) OR "1/1/2001" for "I need to renew/get one"
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MM
/
DD
/
YYYY
P) Nationality where Passport was issued OR "I need to renew/get one"
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Your answer
Traveler long-sleeve T-SHIRT SIZE
S
M
L
XL
XXL
Clear selection
G) Traveler TOUR ROLE
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Student
Potential Chaperone (mark if interested after you've read the Chaperone Responsibilities located at
http://www.dublinhsmusic.org/ireland.html
Director
Staff
Additional family traveler
Traveler GRADE LEVEL at DHS in the Fall 2021
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Freshman Class of 2025
Sophomore Class of 2024
Junior Class of 2023
Senior Class of 2022
ADULT
MINOR Additional Traveler
M) ENSEMBLE in Mr Polot's Music Program
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Orchestra
Wind
Symphonic
Jazz
Adult/Minor Child- not performing
H) Traveler INSTRUMENT/s playing in Ireland (or n/a for Adult/Minor Child)
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Your answer
R) Traveler SPECIAL MEDICAL CONCERNS OR ALLERGIES (Ex: Diabetic, Epi Pen, Nuts, Bees, etc.) or N/A
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Your answer
S) Traveler DIETARY RESTRICTIONS (Ex: Gluten-Free, Nut Allergies, Lactose Intolerant, etc.) or N/A
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Your answer
Flying with DHS to Ireland
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Yes
No
Flying back home with DHS
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Yes
No
Adult/Emergency contact #1/Mom/Parent #1- Full name. THIS IS REQUIRED FOR ADULT TRAVELERS ALSO. SOMEONE OVER 18, NOT TRAVELING WITH US.
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Your answer
Adult/Emergency contact #1/Mom/Parent #1- Cell Phone ###-###-#### THIS IS REQUIRED FOR ADULT TRAVELERS ALSO. SOMEONE OVER 18, NOT TRAVELING WITH US.
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Your answer
Adult/Emergency contact #1/Mom/Parent #1- EMAIL address THIS IS REQUIRED FOR ADULT TRAVELERS ALSO. SOMEONE OVER 18, NOT TRAVELING WITH US.
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Your answer
Adult/Emergency contact #2/Dad/Parent #2- Full name
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Your answer
Adult/Emergency contact #2/Dad/Parent #2- Cell Phone ###-###-####
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Your answer
Adult/Emergency contact #2/Dad/Parent #2- EMAIL address
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Your answer
I will be making my INITIAL NON-REFUNDABLE DEPOSIT of $300/person via:
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PERSONAL CHECK to DHS Music Boosters mailed to: Dublin Irish Guard Boosters, PO Box 2271, Dublin CA 94568
CREDIT CARD or other online form through the Music Boosters Square web site - ADDITIONAL TRANSACTIONS FEES APPLY
Passport Verification - ALL VALID PASSPORTS MUST BE SUBMITTED BY OCT 31, 2021
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My passport is VALID now: SCAN OR SNAP A PICTURE of the page with your PHOTO, PASSPORT NUMBER and EXPIRATION DATE and send TODAY to Liz Crocker.
LFCrocker@yahoo.com
I need to RENEW my passport: Send nothing now.
I need to APPLY for a Passport: Send nothing now
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