Journey to Jerusalem Registration April 28, 2023 with Rev. Mark Robinson

Journey to Jerusalem May 9, 2023 with Rev. Mark Robinson

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*
Month
Day
Year

If you do not currently have a valid passport, type today's date in the text box.
Date of Expiration*
Month
Day
Year

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*
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
Month
Day
Year
Date of Expiration
Month
Day
Year
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
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) is $3,995. Single room supplement is an additional cost of $1,142. A deposit of $500 is required. $100 of the initial $500 deposit is non-refundable. $2,000 is due by check no later than January 15, 2023 and the balance of payment is to be paid by check on or before March 1, 2023. 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% except for the initial $500 deposit * Enrollment in and payment of deposit constitutes your acceptance of the “Fine Print” in the brochure.

Journey to Jerusalem May 9, 2023 with Rev. Mark Robinson

Passport Information

Personal Information

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

Passport Information

Personal Information

PAYMENT

Deposit and Fees

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