Office of Admission
Hampton University
1^st Floor, Whipple Barn
Hampton, VA 23668

800-624-3328
757-727-5328

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Coordinator/Group Information

Name of Coordinator: Mr. Ms. Mrs. Dr.

E-Mail Address:

Name of Group:

Daytime Phone:

FAX:

Office Address 1:

Address 2:

City, State Zip:

 

Travel & Party Information

Tour Date:

Tour Time: 9:30 am 11:30 am 1:30 pm 3:30 pm

Desired Points of Interest:

Next Destination/Arrival Time: /

# of Students/Chaperones: /

Meal in Virginia-Cleveland/Time: Yes No/

Bus Company/Size of Bus: /

Special Information/Request:

 

Lodging Information

Do you require hotel arrangements? Yes No

If not, provide Hotel Name/Phone: /

# of Rooms Needed:

Smoking Preference: Smoking Non-Smoking

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