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Membership Form
Please complete the form below.
*Indicates required field.

       
 
*Full Name Prefix
 
 
 
       
  Archaeological Project    
   
     
  Academic Information  
     
  *Academic Affiliation  
   
       
  *Street Address (Academic)  
   
       
  *City (Academic)
*State *Postal Code
 
 
 
       
  *Country (Academic)    
   
       
  Academic Phone    
     
     
  Contact Information  
     
  Cell Phone    
     
     
  *Email Address  
   
     
  Nationality  
   
     
  Emergency Contact Information  
   
  Contact Name
Relationship If other, please specify:
 
     
  Work Phone Cell Phone  
   
     
  Health Insurance Information  
     
  *Health Insurance Company  
   
     
  Your Policy Number  
   
     
  Insurance Company Contact Number  
   
     
  Health Issues (allergies, medications)  
 
     
  Immunizations Recommended by the Study Center for those working in Greece
 

 

  Please note: Once submitted this form should be signed and dated upon your arrival in Crete.
     
  Questions/Comments    
   
       
 
          
 

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