REGISTRATION FORM: ISRAEL/JORDAN 2012

After you have read the Tour Conditions, please print this form, fill it out and mail with your payment.

PERSON #1: Full name (first, middle and last names as it appears on your passport) 

PERSON #2: Full name (same as above) and relationship to above:
Home Address 

City

 State + Zip

Home phone

 Business phone

Cell phone

Email address

Person #1- Nametag (informal/nickname):

 Person #2- Nametag (informal/nickname):
Vegetarian (person #1 above):               Yes / No Vegetarian (person #2 above):            Yes / No
Emergency contact (1) Name
(2) Relationship  
 (3) City, ST 
(4) Phone (5) Cell phone

PASSPORT INFORMATION

NOTE:  Passports are required for this trip and cannot expire within 6 months of the return date.

Name

Passport #1: _____________________

(first name as appears on passport)

Passport being applied for;
info will be sent at a later date.

Passport #2: _____________________

(first name as appears on passport)

Passport being applied for;
info will be sent at a later date.
Passport #
    
Issue date
    
Expiration date
    
Nationality    
Birthplace (State)
 
Birth date
    
ISRAEL/JORDAN TOUR:  OCT 14-26, 2012

Option 1: Full Tour (with int'l flights) $4,399.00 each

 Total persons:

 

x  ___  =
Subtotal:

Option 2: Land Only (no int'l flights) $2,710.00 each

NOTE: If you're interested in obtaining your own international flights, it is very important that you contact us before booking your flights so we can be sure you won't miss any events.

x  ___  =
  

Single room supplement:    additional $699.00 =

If you are a single traveler but have arranged a roommate, who are you rooming with?

Total Tour Costs:
  

Amount Enclosed (Payable to WWE):

Minimum $300 non-refundable deposit per person
 $

Group travel insurance (per person)

Strongly recommended. Details on"Policies & Conditions"

  $175 pp covers Full Tour ($4,399 pp)

  $215 pp covers Full Tour ($4,399 pp) plus Single Room ($699)

  $125 pp covers Land Only ($2,710 pp) - no flights included

NOTE:  Travelers/residents from the states of Indiana, New Hampshire and Washington must receive a state-specific Description of Coverage, so if this includes you, either contact our agent directly at itcterry1@carolina.rr.com for this information, or contact us at tours@wweministries.org.
x  ___  =

Payable to

"International Travel Center"

ATTN: Terry Gaffney

1501 East Third Street

Charlotte, NC 28204

PHONE: 704-372-5200

 

  $

NOTE: Final payments are due by July 16, 2012.

CREDIT CARD PAYMENTS: WWE accepts credit card payments for an additional processing fee of 2.7% (Visa, MasterCard or Discover) or 3.1% (American Express). Please call the WWE office for this service at 888.993.1997. 

I have carefully read all the information pertaining to this tour and I agree to its conditions.

 Signature:  ____________________________________   Date: _____________________ 
      Send this completed form with check payable to:

WWE, PO BOX 471011, CHARLOTTE, NC 28247-1011
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