Indian Hills Community College - Fine Arts Trip Registration Form

First Name * Required field

Last Name * Required field

Address * Required field

City * Required field

State * Required field

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Cell Phone

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One hour of in–state credit is required and is included in the cost of the trip.
In–State students opting for additional credit must pay an additional $144.00 per credit hour.

Out–of–State students must pay an additional $72.00 for one hour of out–of–state credit.
Out–of–State students opting for additional credit must pay an additional $216.00 per credit hour.

I request credit as:*

In–State Out–of–State (additional charge) Required field

I request credit for:

ART 103: Art Excursions I (1 credit) ART 104: Art Excursions II (1 credit)
(prerequisite: ART 103) MUS 293: Music Excursions (1 credit) CLS 217: Cultural Excursion (3 credits)

Hotel Options:*

Four People in One Room
(included in trip price) Three People in One Room
(additional: $27.00) Two People in One Room
(additional: $82.00) Your Own Room
(additional: $243.00) Required field

Roommate(s) request
(full name for each)

In case of illness, accident, or emergency, contact:

Full Name * Required field

Relationship to applicant * Required field

Address * Required field

City * Required field

State * Required field

ZIP/Postal Code * Required field

Phone * Required field

I understand that by registering for the trip, I am giving my consent
to abide by the Terms and Conditions

I understand and agree: *

Yes No Required field

Fine Arts Trip Registration Form

Please complete and submit the form below to register for the Memphis Fine Arts Trip:

The Arts