Home Outreach
Registration Form I

Journey to the Homeland Tour
North Dakota State Univesity Library, Fargo
20 May - 30 May 2009


Tour including Odessa, Ukraine, the former German villages and Stuttgart, Germany.

The price of the tour is $4,850 per person double occupancy. The first and second payments of $1,500 is due upon registration or by 1 December 2008 (for some registrations, already paid). The second of $1,500 is due by no later than 1 February 2009. The final payment of $1,850 per person is due by no later than 1 April 2009. Add single supplement of $300 for persons requesting a single hotel room.

Please make check payable to NDSU Libraries and mail together with this completed form to the following address: Journey to the Homeland Tours, Germans from Russia Heritage Collection, NDSU Library, P.O. Box 5599, Fargo, ND 58105-5599.

Person registering for the tour may wish to make full payment of $4,850 per person double occupancy plus $300 for single supplement hotel room if desired.


Please complete and return the information below:

Information sheet for tour participants (If a couple or additional persons, each person should complete a separate form. Please make duplicate copies of forms if necessary.)

Please complete the following:
(If available, please type)

Name:
(Include maiden name for married women)

Address:

Daytime phone number with area code:

Evening phone number with area code:

Fax number if available:

E-mail address:

Your approximate age: (circle) 30s 40s 50s 60s 70s

If desired, are you willing to share a room with another male or female. Each person will have separate beds.

Circle: Yes No

Comments:


If you already know another person who will be joining the tour, do you have a preference to share room? Identify name of other person.

Comments:


Please list any health restrictions or concerns.


Do you have any dietary restrictions? If so, please identify.


Do you have any problems with walking?


Name of Black Sea and/or Bessarabian German villages of your ancestors: (Identify if village is in the Black Sea region or the Bessarabian region such as Selz (Kutschurgan, Black Sea or Krasna (Bessarabia). If you wish to visit your ancestral villages, we will need to know the names of the villages.)

1. 6.

2.

7.
3. 8.
4. 9.
5.  

Comments regarding these villages:


Do you have any village maps of the German villages of your ancestors? Please identify which villages?

Have you compiled or published any family histories? If so, please identify the name of the family history and which family names are included along with names of German villages relating to these families.

Please provide any other additional comments about yourself that will be helpful in planning our journey to Ukraine and Germany. Use reverse side of paper or additional sheet of paper if necessary.

Please return this form to:

Michael M. Miller
NDSU Libraries
P.O. Box 5599
Fargo, ND 58105-5599

Permission to use any images from the GRHC website may be requested by contacting Michael M. Miller
North Dakota State University Library
[P.O. Box 5599]
1201 Albrecht Blvd.
Fargo, ND 58105-5599
Tel 701-231-8416
Fax 701-231-7138
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Director: Michael M. Miller
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