Emergency Contact Form

Please complete this form and submit to the AJY Office in Germany.:

* indicates required field

Personal
First Name *
Last Name *
Email Adress *

First Flight
Airline *
Flight Number *
Date of Departure *
Time of Departure *
Departure Airport *
Date of Arrival *
Time of Arrival *
Arrival Airport *

Second Flight
Airline *
Flight Number *
Date of Departure *
Time of Departure *
Departure Airport *
Date of Arrival *
Time of Arrival *
Arrival Airport *
Arrival Terminal in Frankfurt (Terminal 1 or Termial 2) *

Return Flight to U.S.
Date of Departure *
Time of Departure *
Departure Airport *

II. Please indicate when and how you will be meeting the group:
I will book a flight leaving the U.S. on Thursday, August 28 arriving (if possible) by midmorning in Frankfurt on Friday, August 29, 2008. I will be at the Heidelberg train station at 2:00p.m. on Friday, August 29, 2008. I will not be able to join the group at the above times. I will discuss my travel plans with the AJY staff in Heidelberg soon via e-mail to see what alternative arrival arrangements can be made.
Additional comments:

Contact Information
The American Junior Year at Heidelberg University Heidelberg College 310 E. Market St. Tiffin, OH 44883-2462	telephone: (419) 448-2062 toll-free telephone: 1-800-925-9250 facsimile: (419) 448-2217 E-mail: ajy@heidelberg.edu Web: www.heidelberg.edu/ajy