| GROUP
NAME*
|
|
Contact Information |
| Primary
Contact Person |
| Title |
|
| First
Name*
|
|
| Last
Name*
|
|
| Company
/ Organization Name*
|
|
| Position*
|
|
| Address |
|
State
City/Town |
|
| Country*
|
|
| Telephone*
|
|
| Fax |
|
email
Address
email is Required (please make sure
to enter the correct address)*
|
|
| Your
Website (if you have one) |
|
| Expected
Number of Participants
|
|
| Other
: |
|
Date
of Arrival in Israel*:
|
Departure from Israel*:
|
|
| Alternate Dates:
|
|
| Airline
(if known)
|
|
| Flight
# (if known) |
|
|
Do you need assistance with flights?
|
| Accommodation
Information |
| Category
of Hotel or budget per night:
*
|
budget: |
|
Hotel Locations In Israel
Add No. of Nights in each location: *
Jerusalem
Galilee
Tel Aviv
Dead Sea
Eilat
|
|
Has Your Group Ever Been To Israel?
|
|
What Religious Emphasis Would You Prefer, If Any?
|
| ***No.
of Adults :*
|
|
| ***No.
of Children Under 12 : |
|
| ***No.
of Children 12-18 : |
|
| No. of
Rooms Required :*
|
|
| Handicapped
Facilities:
|
|
| Other
: |
|
| Board
Arrangement:
|
| Breakfast
only |
|
| Breakfast
& Dinner |
|
| Lunches
enroute |
|
| *
Required |
Special Requests /
Remarks:
|
| |