Bless Israel Tour Registration Sephardim Hope International

*Complete the form below to register for the SHI Operation Negev Israel Tour January 13-24, 2008.*
*Bold fields are required*

*Passport Name:Last*
*First*
*Address:*
*City, State & ZIP:*
*Home Phone:*
Work Phone:
Cell Phone:
*Email:*
FAX:
Passport Number:
Date of Issue:
Country of Issue:
*Date of Birth:*
*Select Gender:*
*Is this Your first visit to Israel?:*
*I do not have my passport but have applied for it:*
*I am a citizen of:*
*Roommate or Spouse Name:*
I would like a Single Room Supplement:
*I would like my Name Tag to read:*
Special Needs:	Enter your comments here!
Special Meals:	Enter your comments here!
Seat Request:
Medical Disabilities:	Enter your comments here!
*Emergency Contact:*
*Relation:*
*Phone Number:*	Basic Trip cost is $2,995 (subject to change). Call (408) 422-5498 or email info@SephardimHope.org for additional questions. Single Room Supplement $252.00 By submitting this registration I agree to this tour. After Submitting this registration please click on the link at the Thank You page to purchase the tour. *Non-refundable Deposit of $250 due upon registration (by Oct. 26, 2007).* *You may also pay for the entire trip online - See our payment page after you register here when you click on the link at the Thank You page.* We take Visa, Mastercard and we also use Paypal. SHI has a Secure Certificate for your assurance and ease of use.