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Tour itinerary
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JIL ISRAEL TOUR CONGRESS April 20 26, 2014
REGISTRATION FORM
Pastor Mr. Miss Ms.
Passenger Name (as shown in Passport) ______________________________________________________
Date of Birth: ___________________________ Place of Birth: ______________________________
Email: __________________________________ Telephone/Mobile: _________________________
Home Address: _______________________________________________________________________
___________________________________________________________________________________
Passport Number: ________________________ Date of Issue: _______________________________ (Your passport must be valid for up to six months after the date you enter Israel)
Place of Issue: ____________________________ Date of Expiry: _____________________________
Nationality: _____________________________ Status: ___________________________________
Name of Company/School: ____________________________________________________________
Office/School Address: ________________________________________________________________
Occupation/Profession: ___________________ Company Tel Number: _______________________
JIL Chapter/Country: __________________________________________________________________
Church Pastor: ___________________________ Position Held (if any): ________________________ IN CASE OF EMERGENCY: Name: ______________________________________________________________________________
Address: ____________________________________________________________________________
Contact Numbers: ________________________ Relationship: ______________________________ FLIGHT DETAILS: Departure (for Israel): ____________ Flight No. _________________ Date: _________________
Arrival: _________________________ Flight No. __________________ Date: _________________
TERMS OF PAYMENT: x 50% downpayment on or before January 30, 2015 x 50% full payment on or before February 15, 2015
______________________________________ ___________________________________ Signature of Applicant Date
JANET P. TOMAS
74 MERRION RD.BALLSBRIDGE,DUBLIN 4,IRELAND
23 MAY 1970
PHILIPPINES
jptireland@yahoo.ie
+353 862109821
PD9829842
08 FEBRUARY 2013
DUBLIN,IRELAND
07 FEBRUARY 2023
IRISH
SINGLE
NANNY
DUBLIN
ROSANNA SESTOSO
JOCELYN BAGSANGTOMAS
,APT.2, 9 SERPENTINE AVE.,BALLSBRIDGE, DUBLIN 4, IRELAND
+353 868508617
FRIEND
SK538
SAT. 18/04
10:20
04:15
SK771
SUN.19/04
JANET P. TOMAS
13 FEB .2015
.
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