This is the form you will need to fill out for the Off Broadway signup meeting, Jan. 31.

1. 2019 OFF BROADWAY PAYMENT FORM
There are more people who want to go on this trip than there are seats available. Therefore; at the Jan. 31
AdInk meeting (4:00 Union Meeting Room A), your name will be put in a hat and chosen at random to
determine whether or not you get a seat. A waiting list will be created for those who do not get on the bus.
We are visiting two agencies this year and every student visits both, so there is no need to choose your
agency preferences, as in past years. (Note: If you don’t attend the signup meeting, this means that you
must send this form and payment with someone else, or submit it in advance. See AdInk.org for details.)
Bring this form and $25 with you to the meeting. (There will also be forms available at the meeting.)
Your Name _________________________________________________________
S# _________________________ 919 # _______________________________
PAYMENT
____ $25 Cash
____ $25 Check (made out to AdInk)
STUDENT TRAVEL FORM
Be sure that you’ve also signed and submitted a Student Travel form, which is available at AdInk.org and
handed out at the signup meeting.