Summit: Requests for Students & Flights

Please fill out this form if you’d like to purchase additional spots for students for the BridgeUSA Spring 2023 Summit OR have to change/cancel a flight.

Dates: February 10-12, 2023

Location: Orlando, FL

2022 Summit: Additional Student or Flight Change Request

Student submissions for additional beds at the summit, or flight change/cancellation fees

Name*
Chapter Leader First Name Chapter Leader Last Name
Chapter Name
Student Name*
Student First Name Student Last Name
Student Email
Donation amounts*
- $800 (Request for Additional Students)
- $120 (Cancellation Fee)
- $30 (Flight Change or Cancellation Fee)
If you are cancelling your trip to Orlando and your flight has already been purchased a total of $150 is due.
Credit Card
Card Details
Cardholder Name
Address
Street Address City State / Province / Region ZIP / Postal Code Country
Total
$0.00