Journey to Jerusalem May 2021

Phone Registration: 1-919-275-4477 Mail Registration: Make checks payable & mail to: Jewish Awareness Ministries • P.O. Box 1808 • Angier, NC 27501-1808 Email Address: office@jewishawareness.org

Passport Information
Legal Name*
If you do not currently have a valid passport, just type your legal name in the text box.
Passport Number*
If you do not currently have a valid passport, type all ones in the text box. (111111111)
Authority (as listed in your passport)*
If you do not currently have a valid passport, type the name of the country that will issue your passport.
Date of Issue*
MM
DD
YYYY
If you do not currently have a valid passport, type today's date in the text box.
Date of Expiration*
MM
DD
YYYY
If you do not currently have a valid passport, type today's date in the text box.
Nationality*
Even if you do not currently have a valid passport, enter your nationality.
Personal Information
Title*
Name as you want it on your name badge:*
Preferred Airport Departure City*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Work Phone
Sex*
Age*
Birth Date*
Date Format: MM slash DD slash YYYY
Email*
Would you like to receive email updates about your trip?
- Yes
- No
Emergency Contact*
First Last
Relationship*
Phone
Your Roommate:
First Last
I would like to be paired with a roommate
- Yes
- No
I would like a single room (availability limited) for an additional cost
- Yes
- No
COMPLETE THIS SECTION IF A CHILD OR SPOUSE IS TRAVELING WITH YOU
Passport Information
Legal Name
Passport Number
Authority (as listed in your passport)
Date of Issue
MM
DD
YYYY
Date of Expiration
MM
DD
YYYY
Nationality
Personal Information
Title
Name as you want it on your name badge:
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home or Cell Phone
Sex
Age
Birth Date
Date Format: MM slash DD slash YYYY
PAYMENT
Via Check
- Yes
Payable to Jewish Awareness Ministries
Deposit and Fees
Price: Total cost per person, based on double occupancy (includes all taxes, tips and entry fees) will be posted in mid-June. Single room supplement is an additional $1,040, if available. When possible, we will try to arrange for a roommate, if requested. A deposit of $500 is required at time of registration with $100 of the deposit being a non-refundable administration fee. $2,000 is due by check no later than Dec. 1, 2020 and the balance of payment is to be paid by check on or before Feb. 1, 2021. Credit cards can be used for deposit. Call 919-275-4477. Make checks payable to & mail to: Jewish Awareness Ministries, P.O. Box 1808, Angier, NC 27501-1808. Email Address: office@jewishawareness.org. Reserve your seat today for this exceptional tour! Credit card charge of 3% * Enrollment in and payment of deposit constitutes your acceptance of the “Fine Print” in the brochure.

Make a Secure Credit Card Payment Below

You can pay your $500 deposit at our secure credit card site, by entering “Israel Trip,” and clicking the button.

Clicking the button will take you to our secure credit card site.

Journey to Jerusalem May 2021

Passport Information

Personal Information

COMPLETE THIS SECTION IF A CHILD OR SPOUSE IS TRAVELING WITH YOU

Passport Information

Personal Information

PAYMENT

Deposit and Fees

Make a Secure Credit Card Payment Below

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