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Information Request for
Antarctic Peninsula, South Georgia and Falkland Islands
Scotia Arc Tectonics, Climate and Life
December 27, 2012 to January 20, 2013

This special expedition is ponsored by The Jackson School of Geosciences of The University of Texas at Austin and the 125th anniversary of the Geological Society of America, in cooperation with Cheesemans' Ecology Safaris.

We encourage you to sign up early for this voyage to get the best cabin choice. It is an extremely unique voyage and we expect it to fill quickly. Feel free to contact us by any method convenient for you, including this request form. As always, we will not share your information with anybody.

*First Name
*Last Name
Address
City
State or Province
Zip or Postal Code
Country
Phone
*Email
*Retype Email
Affliation
(check all that apply)		 Jackson School of Geosciences
The Geological Society of America
Other
What are your interests?
(check all that apply)		 General
Structural Geology
Climate and Ice Geoscience
Biology
Birding
Botany
 Conservation
Hiking
Photography
History
Wildlife Watching
Other
How did you hear about us? Magazine ad
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Other:  
Want to receive our quarterly email newsletter? yes      If you already subscribed, you can unsubscribe here.
no
Are you a nonsmoker (we take only nonsmokers)? yes
no
Are you interested in being out in the field all day? yes
no
Traveled with us before? yes
no
*How should we contact you? Telephone
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Have any comments and questions?
*Required information

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All material © Cheesemans' Ecology Safaris.
All photos © Doug or Ted Cheeseman, unless otherwise credited.
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