Welcome to Great Lakes Hybrids 2011 Customer Incentive Program to Aruba, the "Happy Island". The trip includes: Round trip air from selected cities, round trip transfers in Aruba, hotel accommodations at the Westin Aruba Resort, daily breakfast and beverage package, welcome reception and farewell dinner for two people. This form must be completed with your legal name as shown on your passport. Incomplete or incorrect names will result in denied boarding by the airline or costly name change fees.
Legal First & Middle Name (middle name required):
Legal Last Name:
Badge Name (First only):
Please Check:	Male Female
Date of Birth, Month/Day/Year:
Email Address:
Street Address (no PO Boxes):
City, State, Zip:
Day Phone:
Cell Phone:
Dealer #:
Guest First & Middle Name (middle name required):
Guest Last Name:
Guest Badge Name (First only):
Please Check:	Male Female
Date of Birth, Month/Day/Year:
NUMBER IN ROOM: Maximum of 4 guests in a room, all adults or adults and children.
If More Than 2 in Room, List Full Legal Names, Ages, Sex and Date of Birth for Each additional person:
Emergency Contact Name:
Relationship:
Day Phone:
Cell Phone:
Trip Type:
Preferred Bedding, on request only:
Departure City:
If Departure City is "Other", list the requested departure city (requests for a departure city other than those listed or for specific flights are based on availability; any additional cost is your responsibility):
Special Requests:
$200 Deposit Is Required To Hold Travel Reservation:
IF PAYING BY CREDIT CARD, Provide Name on Card:
Provide Credit Card Number / Exp Date / CID#:
Provide Billing Address for Card:
List the units of GLH Seed purchased using travel discounts or new customer travel program : CORN
List the units of GLH Seed purchased using travel discounts or new customer travel program : ALFALFA
List the units of GLH Seed purchased using travel discounts or new customer travel program: SOYBEANS
Any change in the amount of seed purchased may affect the travel discount. Your travel discount will be based upon your final NET corn and alfalfa units purchased for 2010-11 sales year. Final purchased units will be verified and the corresponding travel discount may be adjusted at final settlement.
TRIP PAYMENT: A minimum of the trip value, less your projected discount, must be paid to Great Lakes Hybrids toward your seed order total by October 29, 2010.	Use my travel discount plus Signature Rewards for the balance Use my travel discount, I will pay the balance by October 29, 2010 New customer travel program